Description
X-ray taken using film.

Guidelines/Instructions

  • This modifier is effective for services provided on or after January 1, 2017
  • Providers must submit this modifier with the X-ray CPT code for each X-ray taken using film
  • Effective for claims with dates of service on and after January 1, 2017, a 20 percent payment reduction applies to the technical component (and the technical component of the global fee) of the MPFS amount when an X-ray procedure is taken using film
  • Use of HCPCS modifier FX for these services will result in the applicable payment reduction
  • When the payment reduction is made, the following remittance messages will be used:
    • Claim Adjustment Reason Code 237 — Legislated/Regulatory Penalty. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an alert).
    • Remittance Advice Remark Code N775 — Payment adjusted based on X-ray radiograph on film; and
    • Group Code: CO (contractual obligation)    

Resources

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