Description
Item or service furnished to a patient that is not for the treatment of ESRD.

Guidelines

  • Submit this modifier on Part B claims for end-stage renal disease (ESRD) patients for specific lab services and drugs/biologicals that are not related to the treatment for ESRD. This modifier will allow payment for these non-ESRD services outside of the ESRD Prospective Payment System (PPS) if all other coding and coverage requirements are met (excluding services/drugs that CMS has determined to always be included in the PPS).

References

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

Email JJ Part B

Contact a specific JJ Part B department


Click to Chat Now