DME Coding

“With the loss of CPT 99343, is time a justification for the use of CPT 99344? My initial home visits (and now assisted and congregate living facilities) easily meet or exceed sixty minutes. Before I see patients, they completed a five page demographics that includes two pages of review of systems. I also have the chart notes from the referring physician and/or the CMS-485 from a home care agency (or the input paperwork from the hospice agency) that is all reviewed while face to face with the patient. The physical exam is quite time consuming in and of itself followed by assessment, treatment, plan of care and coordination of care. It seems that everything I can read says that I am justified in billing CPT 99344 using time. Thoughts?”

“I billed A5500 and A5512 with modifiers -KX, -RT, -LT. L1940 KXRTLT L2330 KXRTLT L2820 KXRTLT I billed these on separate lines. This claim was rejected so we re-billed putting the KX modifier in the 3rd spot and it was still rejected for the same reason. The comment was: 4 – the procedure code is inconsistent with the modifier used or a required modifier is missing Any thoughts on how to tackle this denial?”