Rank: New Member
Joined: 3/24/2017(UTC)
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I am using Modifier NU for New unit when I am billing for E0486 and I have now received 2 denials that say.... DME must be billed with the appropriate rental or purchase modifier and guidelines were not met.
I only know to use this modifier, is there something different I should be doing?
Thank you
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi CODCLAKE!
You are correct - NU is the appropriate modifier to use when billing E0486 for custom made oral appliances for OSA. NU stands for "new equipment", which indicates a purchase of a piece of DME rather than a rental.
If you would like to give me the name of the insurer, I would be happy to see if I can locate their medical policy for oral appliances for OSA to see if their policy offers any coding information that may shed some light on the denial.
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