Modifier KL (2021)
KL DMEPOS Item Delivered via Mail
Contract suppliers must use the KL modifier on all claims for diabetic supply codes that are furnished via mail order. Non contract suppliers that furnish mail order diabetic supplies to beneficiaries who do not live in CBAs must also continue to use the KL modifier with these codes. Suppliers that furnish mail-order diabetic supplies that fail to use the HCPCS KL modifier on the claim may be subject to significant penalties.
Effective January 1, 2009, the KL modifier has been changed from an informational modifier to a pricing modifier in the HCPCS file.
KL modifier will need to be used for all diabetic supply codes except for claims for items that a beneficiary or caregiver picks up in person from a local pharmacy or supplier storefront.
Modifier KL is applicable only for the below listed HCPCS codes
A4256 Normal, low, and high calibrator solution/chips
A4258 Spring-powered device for lancet, each
A4259 Lancets, per box of 100
Please note: Inappropriate use of a competitive bidding modifier on a competitive bidding claim is in violation of the law and may lead to claims denial and/or other corrective actions. The use of a competitive bidding modifier does not supersede existing Medicare modifier use requirements for a particular code, but rather should be used in addition, as required.
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