Billing and collections for Durable Medical Equipment (DME) can best be enhanced by using the appropriate modifiers for the equipment rented/bought. There are two scenarios in which the DME is often purchased/rented. Inexpensive DME consists of the equipment whose cost does not exceed $150; wherein routinely purchased DME is the equipment which is high in use and purchased 75% of the time, or it is rented if the maintenance cost is very high. People usually pay a lump sum or rent the expensive DME for the time they require it. However, the total payment should not exceed the actual charges of the purchase.
For such categories, certain modifiers are used which enhance billing and collections. As the name suggests, modifiers amend a service/procedure/equipment for apposite reimbursement. They add to the information/documentation provided by the physician and give more specificity for the service/product rendered. The reimbursements differ as per the modifiers used/appended while submission for insurance. Hence when DME is a rental, the modifier RR is used for enhancing billing and collections. It comes under the Level II HCPCS modifiers which consist of two digits beginning from AA through VP and usually comprise alpha/alphanumeric characters. This modifier must be used on all claim forms for rental DME. The beginning and end dates of renting must be mentioned in the claim form.
Using the modifier RR for improving revenue flow:
In the form, Modifier RR must be stated in the first modifier location of field 24D. If not mentioned, the DME is considered as a purchase and not reimbursed accordingly. Again, the recipient must have used the services and the bill must be claimed after 30 days of rental (as one unit), unless it is being used on a daily basis. In case, the equipment is still being used, the claim form must include the beginning date and the end date of service is considered to be the last day of the billing cycle.
Specific DME using Modifier RR:
Claims for 'non-wheelchair' rentals which are generally obtained from manufacturers and henceforth provided to recipients should include the Modifier RR while submitting the reimbursement form. Another category that must use Modifier RR are the 'Lymphedema pumps/compression devices - pneumatic' when rented and the adequate documentation must be provided for its effectiveness. 'Segmental pneumatic' appliances may also use the Modifier RR (rental) in case of reimbursement for HCPCS codes E0656 and E0657. Moreover, 'positioning seats' can be claimed under DME equipment as a rental. The modifier RR can be used here but reimbursements are only 'By Report' along with the billing of Code T5001. Again, 'wearable cardiac defibrillator (WCD)' HCPCS code K0606 can be reimbursed as a rental by using modifier RR on a monthly basis.
However, 'prefabricated helmets' or 'helmet interface replacement HCPCS code A8004' are not allowed to be rented hence RR modifier cannot be used for this category. Modifier RR can bring accurate reimbursements if used appropriately.
