CommercialAdministrativeMedium impact
PAP222 - Durable Medical Equipment/Prosthetics/Orthotics/Supplies (DMEPOS)Modifiers - Added clarifying language
Blue Cross of Idaho·ID · PM&R (Physical Medicine & Rehab), Pulmonology, Wound Care·Medical Policy
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho added clarifying language to their DMEPOS modifier policy (PAP222). The policy reinforces existing requirements for proper modifier usage (RR for rental, LL for lease, NU for purchase) and provides specific guidance for oxygen equipment, breast pumps, and various accessories.
Action Required
Immediately: Billing team must verify all DMEPOS claims include correct modifiers (RR for rental, LL for lease, NU for purchase). For oxygen codes E0424, E0439, E1390, E1391, ensure QE/QF/QG modifiers are used appropriately and portable equipment claims are submitted same day when using QF modifier. Use NU modifier for oxygen accessories E1353 and E1355. Claims without proper modifiers may be rejected or default to rental pricing.