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Modifier KX Fact Sheet


  • Requirements specified in the medical policy have been met

Appropriate Usage

  • When additional documentation is available to support the medical necessary service under a medical policy

Inappropriate Usage

  • When the claim will be denied for statute
  • When all information is represented on the claim, and the medical notes will not offer any further clarification

CMS Resource:
CMS Internet Only Manual (IOM) Publication 100-4, Chapter 5, Section 10.3