DJO has received PDAC letters for its DonJoy Back Braces. These rigid braces have been assigned covered codes and are eligible for reimbursement from Medicare. To view the PDAC letters and the assigned HCPCS codes for each product, please click here DJO PDAC
Author: DME INFO
Current Orthopedic and DME news and resources.
Feds Accuse 94 of Medicare Fraud
Federal authorities have charged 94 people in what U.S. Attorney General Eric Holder called “the largest federal healthcare fraud takedown in our nation’s history.” Those being arrested in Miami, Detroit, Houston, New York and Baton Rouge, La., allegedly participated in schemes to submit more than $251 million in false Medicare claims, Holder announced at a July 16 press conference. Please click here for more information MEDICARE FRAUD
PECOS update-Twenty minutes with CMS’s Jim Bossenmeyer
BALTIMORE – Coming off last week’s confusing Open Door Forum, HME News called Jim Bossenmeyer, director for the division of provider and supplier enrollment at CMS, for clarification on the Provider Enrollment, Chain and Ownership System (PECOS). For more information and the entire article please click here PECOS
CMS to providers: No PECOS grace period
BALTIMORE – CMS officials aren’t cutting HME providers any slack when it comes to complying with the July 6 deadline for the Provider Enrollment, Chain and Ownership System (PECOS). HME providers who take Medicare referrals on or after July 6 from physicians not enrolled in PECOS risk having those claims rejected, CMS officials stated during last week’s Open Door Forum. For more information, please click here PECOS Grace Period
Hand-Finger Orthoses (L3923) – Use of CG Modifier
If a hand-finger garment is made primarily of elastic material, it must be billed with code A4466 (Garment, belt, sleeve or other covering elastic or similar stretchable material, any type, each) and not code L3923. Claims billed with code A4466 will be denied as noncovered, no benefit category. Effective for claims with dates of service on or after July 1, 2010, if an L3923 orthosis has a rigid plastic or metal component, the supplier must add the CG modifier (policy criteria applied) to the code. Claims for L3923 billed without a CG modifier will be rejected as incorrect coding.
Please click here for more information Hand-Finger Orthosis Code Info
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