It never ceases to amaze me...I recently read a post on the O&P List Serve from someone inquiring about a denial for repairs to a C-Leg.

The writer gave the LCode and Modifier for what they were billing, and the first thing I noticed was the incorrect Modifier.  Repair and Replacement Modifiers changed at the beginning of 2009. BILLERS ALERT...PAY CLOSE ATTENTION TO ONGOING CHANGES, as they seem to happen frequently.  If you don't, you risk potential denied claims!

Below is the information posted on one of the Jurisdications website, they all follow the same suit...

"New Repair and Replacement Modifiers

Effective for claims with dates of service on/after January 1, 2009, the RP modifier will no longer be accepted for the use of repair and replacement.

The following modifiers will be required:

RA Replacement of beneficiary-owned DMEPOS due to the expiration of the equipment's reasonable useful lifetime or to loss, irreparable damage, or when the item has been stolen.

RB Replacement parts furnished in order to repair beneficiary-owned DMEPOS.

Please report the appropriate modifier on claims in 2009.

Electronic claims submitted with an RP modifier for dates of service on/after January 1, 2009, will be rejected via an error on the GenResponse report.

Paper claims submitted with an RP modifier for dates of service on/after January 1, 2009 will be denied as an unprocessable with the following reason code: CO-4 The procedure code is inconsistent with the modifier used or a required modifier is missing.

Claims will need to be resubmitted with the correct modifier.