Category: DME Information

Results of Prepay Probe for Lumbar-Sacral Orthoses

Posted on by DME INFO

The DME MAC Jurisdiction A has completed the prepayment probe review of claims for Lumbar-Sacral Orthoses

• HCPCS code L0631 is a Lumbar-Sacral Orthoses, sagittal control with rigid anterior and posterior panels,

posterior extends from sacroccoccygeal junction to T-9 vertebra, produces intracavitary pressure to reduce

load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous

abdomen design, prefabricated, includes fitting and adjustment.

• HCPCS code L0637 is a Lumbar-Sacral Orthoses, sagittal-cornal control with rigid anterior and posterior

frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures,

may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and

adjustment.

This probe was initiated due to errors identified by the Comprehensive Error Rate Testing (CERT) Contractor. Please click here to read the entire probe LSO PROBE

Provider Services Portal Invitation

Posted on by DME INFO

The Centers for Medicare & Medicaid Services (CMS) authorized NHIC, Corp. to design and operate the Provider Services Portal (PSP) to offer DME MAC Jurisdiction A suppliers a means to access beneficiary eligibility and claims information over the Internet. PSP offers an electronic, web-based alternative to the processes of calling or writing the Customer Service Center, or calling the IVR for information.

PSP offers the following information through lookup transactions:

  • Beneficiary Eligibility
  • Claim Status
  • Standard Paper Remittance (SPR)
  • Same/Similar

PSP is available 24 hours a day, 7 days a week, except during scheduled maintenance windows.

At this time, NHIC is offering PSP Open Enrollment to all DME MAC Jurisdiction A suppliers.  Please click here for more information

Medicare Provider-Supplier Enrollment

Posted on by DME INFO

CMS has established Internet-based Provider Enrollment, Chain and Ownership System (PECOS) as an alternative to the paper (CMS-855) enrollment process. Internet-based PECOS will allow physicians, non-physician practitioners and provider and supplier organizations to enroll, make a change in their Medicare enrollment, view their Medicare enrollment information on file with Medicare, or check on status of a Medicare enrollment application via the Internet. For more information about the Internet-based PECOS, please CLICK HERE

CMS Launches Sunshine Website

Posted on by DME INFO

The Sunshine Law (officially known as the National Physician Payment Transparency Program) creates greater transparency around the financial relationships of manufacturers, physicians, and teaching hospitals.

The Sunshine Law requires that the following information is reported annually to CMS:

  • Applicable manufacturers of covered drugs, devices, biologicals, and medical supplies to report payments or other transfers of value they make to physicians and teaching hospitals to CMS.
  • Applicable manufacturers and applicable group purchasing organizations (GPOs) to report to CMS certain ownership or investment interests held by physicians or their immediate family members.
  • Applicable GPOs to report to CMS payments or other transfers of value made to physician owners or investors if they held ownership or an investment interest at any point during the reporting year.

CMS will collect this data, aggregate it, and publish it on a public website.  Please click here for more information: SUNSHINE