Right documents are required on file to support medical necessity for the product ordered which is important not only for billers and coders but also if the claim is facing rejection or in the case of auditing, it can explain the details of the claim. For instance, an XK modifier is known to demonstrate that the supplier has written the order and used the supplies/medicine/equipment to cure the patient. The carry-on of the requested order should be kept on file by the supplier.
This order needs to have the following:
- indicate the diagnosis/reason for the equipment/medication
- proper date
- the provider’s signature
Without the following details, the DME bill claim can be rejected/denied.