Billing L1810 to DME

I have several claims denied by Medicare DME for L1810 'Knee Sleeve Open Patella'. I called DME and was informed by the representative that I need a modifier but of course would not inform me which one. I tried NU and the claims rejected again. Please help. I could not find any info on the Medicare Website. Thank you

Dme

https://www.noridianmedicare.com/dme/coverage/docs/lcds/current_lcds/knee_orthoses.pdf

If appropriate, they may be looking for KX modifier.

DME - KX modifier for HCPCS L-Codes

Effective June 1, 2009, Medicare established new requirements for ankle-foot orthoses. Only claims billed with the KX modifier will be eligible for reimbursement. According to Medicare's policy, the KX modifier should be added only if all the coverage criteria for the product are met and evidence of such is retained in the supplier's files and available to the DME MAC upon request. The detailed coverage criteria are outlined in the Medicare policy. You can access the Medicare policy on the DME MAC websites. GOOD LUCK WITH THIS! I think the CMS website is horrendous and continuously sends you in circles. For example, I have the LCD information on L1906 which states "For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category (I have know idea how to determine this), 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member (perhaps I'm naive but I would hope that a provider would not issue this DME if it was unnecessary, e.g., for a fracture), and 3) meet all other applicable Medicare statutory and regulatory requirements (again, I have no idea how to determine this).

I welcome any input you can offer back to me as my frustration level is sky high.
Pamela Schaaff, Orthopedic and Podiatry Coding, Exeter, N.H.

DME fraud is rampant

That is why they have this wording. The good guys have to jump through hoops so the criminals can be caught. Organized crime is making millions on Medicare fraud and DME is an easy money maker.