HCPCS Modifier KP

Published 01/30/2023

Description
First drug of a multiple drug unit dose formulation.

Guidelines and Instructions
Append to appropriate code (one of the unit dose form codes) when two or more drugs are combined and dispensed to the beneficiary in the same unit dose container; each drug is billed using its unit dose form code. Append the KQ modifier to other unit dose code(s).

  • Except for code J7620, when two or more drugs are combined and dispensed to the patient in the same unit dose container, each of the drugs is billed using its unit dose form code. The KP modifier is added to only one of the unit dose form codes and the KQ modifier is added to the other unit dose code(s). Whenever a unit dose form code is billed, it must have a KO, KP or KQ modifier. (Exception: The KO, KP and KQ modifiers should not be used with code J7620.) If a unit dose code does not have one of these modifiers, it will be denied as an invalid code. The KO, KP and KQ modifiers are not used with the concentrated form codes. The only FDA-approved unit dose preparation containing more than one drug is J7620, the combination of albuterol and ipratropium. Therefore, if the following FDA-approved unit dose codes are billed with a KP or KQ modifier, they will be rejected as invalid for claim submission: J2545, J7608, J7613, J7614, J7626, J7631, J7639, J7644, J7669, J7682 and Q4074.

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