Durable Medical Equipment Resource Blog
Recently the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) and the Pricing Data Analysis & Coding (PDAC) contractor received questions regarding coding guidelines for Ankle Foot Orthosis. In an effort to address these questions, the following definitions for certain orthoses will clarify their meaning and assist suppliers in correct coding of these devices.
Please click here for more information CODING GUIDELINES
DMEPOS suppliers are reminded that the CMS-855S enrollment application was recently revised to capture additional information pertinent for enrollment processing. Suppliers should use the CMS-855S version (07/11) if enrolling in Medicare for the first time, reporting changes to existing enrollment, if you have been asked to revalidate your existing enrollment, and other limited circumstances.
The 07/09 version of the CMS-855S will only be accepted through December 31, 2011. Any information received on the obsolete form after this point will be returned to the supplier resulting in a delay to your enrollment activities.
Download and begin using the revised version today by accessing the forms by clicking here: CMS Forms
2012 DMEPOS FEE SCHEDULE
The DMEPOS fee schedules are updated on an annual basis in accordance with statute and regulations. The update process for the DMEPOS fee schedule is located in Pub.100-04, Medicare Claims Processing Manual, chapter 23, section 60B. Policy: This recurring update notification provides instructions regarding the 2012 annual update for the DMEPOS fee schedule. Payment on a fee schedule basis is required for durable medical equipment (DME), prosthetic devices, orthotics, prosthetics, and surgical dressings by §1834(a), (h), and (i) of the Social Security Act. Please click here for 2012 Fee Schedule.
If you are looking for PDAC letters for DJO products, they can be found on the DJO Corporate Compliance website at: http://www.djoglobal.com/en_US/Coding.html
If the product you are looking for is not listed there, it means that DJO has not submitted a PDAC application for that particular product, or has not yet received a PDAC letter in response to an application. All PDAC letters are posted immediately upon receipt. Please be advised that DJO has obtained PDAC letters where required – which includes all knee braces coded L1845 and all rigid back braces. (As of September 1, 2011, PDAC letters will be required for cervical collars coded L0174.)
Questions about PDAC letters should be directed to the appropriate DJO marketing manager or to corporate.compliance@djoglobal.com.
Hear from the Office of Inspector General and other government experts as they educate local health care providers, compliance officers, and their legal counsel about the realities of Medicare fraud and the importance of implementing an effective compliance program.
This free compliance training is offered by the U.S. Department of Health and Human Services, Office of Inspector General. No registration is required to view this event. Please follow this link for more information HEAT
DME INFO 