March 19, 2009
Oxygen Replacement Claims and the RA Modifier
CGS has recently observed the overuse of the RA (Replacement of DME item) modifier on Oxygen claims.
The RA modifier must be added to the oxygen equipment HCPCS code E1390, only if:
- It is the initial rental month
- It is for a replacement due to reasonable useful lifetime, or replacement due to damage, theft, or loss.
Adding RA modifier when not required may result in a delay in claim processing.
As a reminder, the RA modifier should not be used when billing for a new initial rental that follows a 60+ day break in need.