Noridian

Are you up to date with the required modifiers for external infusion pumps? Ensuring correct coding and billing is crucial for compliance and reimbursement. The required modifiers can be found in Local Coverage Determination (LCD) L33794
EY – No physician or other licensed health care provider order for this item or service
GA – Advance Beneficiary Notice of Noncoverage (ABN) issued; policy criteria not met
GY - Item or service statutorily excluded or does not meet the definition of any Medicare benefit
GZ – Item or service expected to be denied as not reasonable and necessary
JB - Administered subcutaneously
JK - One month supply or less of drug or biological
JL - Three-month supply of drug or biological
JW - Drug amount discarded/not administered to any patient
JZ - Zero drug amount discarded/not administered to any patient
KX - Requirements specified in the medical policy have been met

Stay compliant and ensure your claims are processed smoothly. For more detailed information, visit the Noridian Medicare Website.

JA: https://bit.ly/4jg3UBj
JD: https://bit.ly/3EC2txZ

Unlock the Noridian Education Experience—your self‑paced training resource available 24/7! Whether you're new to DME or looking to sharpen your expertise, these tutorials give you convenient, anytime access to essential Medicare education.

Explore our Oxygen and Oxygen Equipment tutorials, where we walk through the five key coverage requirements for this policy in a clear, easy‑to-understand format. Perfect for strengthening compliance and boosting confidence in your documentation and billing practices. Learn at your pace. Train on your schedule. Access your Noridian Education Experience today!

Concurrent Use of Oxygen and Positive Airway Pressure (PAP)
Dear Physician Prescribing Home Oxygen
Oxygen: Coding and Billing Guidelines
Oxygen: Coverage Guidelines
Oxygen: Testing Requirements
JA: https://med.noridianmedicare.com/web/jadme/education/noridian-educational-experience
JD: https://med.noridianmedicare.com/web/jddme/education/noridian-educational-experience