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(h) Payment for drugs covered as additional preventive services (DCAPS)

To fulfill this statutory obligation and to address the completeness and accuracy of the rebate amount, CMS proposes to conduct regular reconciliations at two points in time to determine whether the rebate amount must be adjusted due to updated claims and payment data used in the calculation of such rebate amount (specified in proposed 428.401(d)(1)): (1) 12 months after the issuance of the Rebate Report, and (2) 36 months after the issuance of the Rebate Report

We believe that usage of the KX modifier in the context of claims for dental services inextricably linked to covered services to indicate that the clinician attests that the service is medically necessary, and that the provider has included appropriate documentation is appropriate and will support claims processing and program integrity efforts

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Med 39 , 141148 (2010)