RETIRED - Billing Reminder - Urological Supplies

IMPORTANT: THIS DOCUMENT CONTAINS OUTDATED INFORMATION.

Content Provided on this page contains outdated information and instruction and should not be considered current. Noridian is providing this archived information for research purposes only. This archived article contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

Article retired due to content incorporation into the applicable Local Coverage Determination or related Policy Article.

September 09, 2011

The DME MAC A Outreach & Education Team would like to remind the supplier community that many urological supply HCPCS codes include payment for other items. In these cases, the included items are not separately payable by Medicare and should not be submitted on the claim.

When providing the urological supply HCPCS listed in Column II, the Column I code must be used instead of billing separate Column II codes when the items are provided at the same time.

Column I Column II
A4310 A4332
A4311 A4310, A4332, A4338
A4312 A4310, A4332, A4344
A4313 A4310, A4332, A4346
A4314 A4310, A4311, A4331, A4332, A4338, A4354, A4357
A4315 A4310, A4312, A4331, A4332, A4344, A4354, A4357
A4316 A4310, A4313, A4331, A4332, A4346, A4354, A4357
A4354 A4310, A4331, A4332, A4357
A4357 A4331
A4358 A4331, A5113, A5114
A5105 A4331, A4358, A5112, A5113, A5114
A5112 A5113, A5114

 

If a urological supply HCPCS code exists that includes multiple products, that code should be used in lieu of the individual codes.

Suppliers should contact the Pricing, Data Analysis and Coding (PDAC) Contractor for guidance on the correct coding of these items. The PDAC can be reached at 1-877-735-1326 or http://www.dmepdac.com.

 

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