Respiratory Question for the Week of April 3, 2017

Question:

Can we get paid for submitting a Medicare claim for stationary oxygen equipment with the QG modifier AND a claim for portable oxygen equipment with the same date of service?

Answer:

In the case you describe, your claims would be returned as unprocessable due to the incorrect use of the modifier, according to the Centers for Medicare & Medicaid Services (CMS) in provider-information memo MM9848. CMS also states that neither the claim for stationary oxygen equipment with the QG modifier nor the claim for portable oxygen equipment is valid. There is no way for Medicare to know whether the first submitted claim was billed incorrectly or the subsequent claim was billed incorrectly.