DME MAC Jurisdiction C Modifier

BA — ITEM FURNISHED IN CONJUNCTION WITH PARENTERAL ETERNAL NUTRITION (PEN) SERVICES. (EFFECTIVE DATE 1/1/2003)When an IV pole (E0776) is used in conjunction with parenteral nutrition, the BA modifier should be added to the code. Code E0776 is the only code with which the BA modifier may be used.

GZ — ITEM OR SERVICE EXPECTED TO BE DENIED AS NOT REASONABLE OR NECESSARY. (EFFECTIVE 1/1/2002)

QV — ITEM OR SERVICE PROVIDED AS ROUTINE CARE IN A MEDICARE QUALIFYING CLINICAL TRAIL (ENDS 12/31/2007)

GY — ITEM OR SERVICE STATUTORILY EXCLUDED, DOES NOT MEET THE DEFINITION OF ANY MEDICARE BENEFIT OR, FOR NON-MEDICARE INSURERS, IS NOT A CONTRACT BENEFIT (UPDATED 1/1/2008)

FB — ITEM PROVIDED W/O COST TO PROVIDER, SUPPLIER OR PRACTITIONER, OR FULL CREDIT RECEIVED FOR REPLACED DEVICE (UPDATED 1/1/2008)

QR — ITEM/SERVICE IN MEDICARE STUDY – OXYGEN (ENDS 12/31/2007)

LT — LEFT SIDE. (USED TO IDENTIFY ITEM PROVIDED FOR THE LEFT SIDE OF THE BODY.)