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WCH News

UHC DME Modifier Requirement in 2013

Thursday, November 8, 2012


Effective January 1, 2013, UHC will require that items eligible for purchase or rental be submitted with the appropriate modifier(s) designating which is being billed. The policy now states that if a modifier is not applied, the charge will be considered a purchase. IF an item is eligible for either rental or purchase, and you do not submit it with the required modifier, the claim will be denied and returned.

For those codes on UHC fee schedule that allow both rental and purchase, one of the following modifiers must be reported:

  • RR - Rental
  • KH - Initial claim, purchase or first month rental
  • KI - Second or third monthly rental
  • KJ - Capped rental months four to fourteen
  • KR - Partial month
  • NU - New Equipment
  • UE - Used Equipment

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