Wednesday, July 28, 2010

Live Kidney Donor Services - Q3 Modifier

Live Kidney Donor Services - Q3 Modifier

 Medicare Part B makes reimbursement for live kidney donor services performed during the preoperative, intraoperative, and postoperative periods. These services should be billed to the carrier under the name and Health Insurance Claim Number (HICN) of the kidney recipient.

Providers should submit live kidney donor preoperative, intraoperative, and postoperative services with modifier Q3, "live kidney donor surgery and related services." This modifier allows 100% reimbursement of the live kidney donor's medical services.

Providers should report the transplant surgery (codes 50320 or 50547) and anesthesia charges (code 00862) to Medicare Part B for the living donor. These services should be billed under the Medicare number of the beneficiary who is receiving the transplant services.

For covered postoperative care/services for the live kidney donor, the Q3 modifier must be reported with the service in order to receive 100% reimbursement. If the modifier is not reported, Medicare Part B will not be able to determine that the services are for the donor and reimbursement may be denied or not allowed at 100%.

If the kidney donor services are from a cadaver, they are considered part of the organ acquisition program and should be billed to Medicare Part A. 

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