Medical Director Articles - 2013 and Prior

The term "article" is used to describe any bulletin article, web site article, educational handout or any other non-LCD document intended for public release that contains coverage/coding statements or medical review related billing or claims considerations.

Articles address local coverage, coding or medical review related billing and claims considerations, and may include any newly developed educational materials, coding instructions or clarification of existing medical review related billing or claims policy.

These articles are written collaboratively by all DME MAC Medical Directors and posted on all DME MAC websites.

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Articles Source
AC/DC Power Adapters and Backup Batteries DMD
Advanced Beneficiary Notice (ABN) and Complex Medical Record Review DMD
AFO/KAFO LCD related Policy Article - Revised DMD
Albuterol and Ipratropium - Revised Coding Guidelines DMD
Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement DMD
Appropriate UPIN Usage DMD
Billing for Capecitabine (Xeloda®) 500 mg Dosage Form - European Formulation Blister Pack DMD
Billing for Denial of Items Previously Listed in the Home Dialysis Equipment and Supplies LCD for Non-ESRD Beneficiaries DMD
Billing for Implanted DME, Prosthetic Devices, Replacement Parts, Accessories and Supplies DMD
Billing Of DMEPOS With Chiropractors As Referring Physician DMD
Billing Reminder - AFO/KAFO Prefabricated Base Orthoses and Custom-Fabricated Additions DMD
Billing Reminder - Billing for Supplies Prior To Delivery of the Base Item DMD
Billing Reminder - Lower Limb Suction Valve Prosthesis DMD
Billing Reminder - Repairs to Capped Rental Durable Medical Equipment (DME) DMD
Billing Reminder for Knee Orthoses Addition Codes DMD
Billing Reminder: Nebulizers - Pharmacy Dispensing Fees for Inhalation Drugs DMD
Biofeedback for Urinary Incontinence DMD
Breathing Circuits - Billing Instructions DMD
Can a Beneficiary Simultaneously Qualify for a Wheelchair and a Seat Lift Mechanism? DMD
Centers for Medicare & Medicaid Services Approved Clinical Trials DMD
Charges Imposed By Family Members Of Patient DMD
CIGNA Medicare to Process Claims for Medicare Beneficiaries Participating in Federally Sponsored Clinical Trials DMD
Clarification on Submission of the Correct “Amount Paid” on Assigned Claims - Item 29 of the CMS-1500 Claim Form or Electronic Equivalent DMD
Clinical Trials CIM Revision Added DMD
Clinical Trials Routine Care Services Diagnosis Coding Instructions DMD
Comprehensive Error Rate Testing (CERT) Physician Letter - Glucose DMD
Concentric Adjustable Torsion Joints - Correct Coding DMD
Consumable Supplies - Request for Refill Documentation Requirements DMD
Continuous Passive Motion Machine Coding Guidelines DMD
Continuous Positive Airway Pressure CIM Revision DMD
Correct Billing for Upper Limb Prosthesis with L6895 instead of L7499 DMD
Correct Billing Of Vision Codes DMD
Correct Coding - L0174 Coding Review (PDAC Advisory Article) DMD
Correct Coding - Safety Equipment Packages with Power Operated Vehicles (POVs) DMD
Correct Coding - Safety Equipment Packages with Power Operated Vehicles (POVs) DMD
Correct Coding - Supplies used with E0446 - Joint DME MAC Publication DMD
Coverage Reminder - Chiropractor Limitations DMD
Coverage Reminder - Chiropractor Limitations DMD
Coverage Reminder - Safety Lancets Non-covered DMD
Coverage Reminder - Testing for Oxygen and Oxygen Equipment Coverage DMD
CPAP Documentation And KX Modifier Usage DMD
CPAP Policy DMD
Deceased Physicians’ UPINs on DMERC Claims DMD
Delivery of Orthoses or Other DMEPOS Items and Hospitalization DMD
Deported Medicare Beneficiaries DMD
Detailed Written Orders and Face-to-Face Encounters DMD
Devices Used for Edema or Ulcer Healing - HCPCS Code A9283 DMD
Diabetic Supplies and Correct Units of Service DMD
DME Upgrades, ABNs and Claims Modifiers DMD
DMEPOS Billing Procedures DMD
DMERC Coverage Of Treprostinil (Remodulin) DMD
DMERCs - Pre-Discharge Delivery of DMEPOS for Fitting and Training
Drugs Used With External Infusion Pumps - Coverage and Billing Reminders DMD
Durable Medical Equipment Ordered With Surrogate Unique Physician Identification Numbers (UPIN) DMD
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Claims During an Inpatient Stay DMD
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Provided During an Inpatient Stay - ANSI Denial Code CO-97 (Change Request 7189) DMD
E0486 - Custom Fabricated Oral Appliance for OSA - Coding and Utilization Guidelines DMD
Electrical Joint Stimulation Devices - E0762 - Coding Guidelines DMD
Exercise Equipment - Correct Coding DMD
Expanded Coverage of Diabetes Outpatient Self-Management Training DMD
External Breast Prostheses Webinar - 10/20/2012 - Event Question and Answer Summary DMD
FAQ - Refill Requirements for Non-consumable Supplies DMD
Forgotten ZX Modifiers DMD
Frequently Asked Questions: Oxygen Use in Beneficiaries with Obstructive Sleep Apnea DMD
Glucose Monitor Supplies - Use of Upgrade Modifiers - Revised DMD
Glucose Monitor Supplies - Utilization Reminder DMD
Glucose Monitors and Supplies LCD - Clerical Correction DMD
HCPCS Code L0430 - Invalid (PDAC Article) DMD
HCPCS Code Update - 2012 DMD
Home Prothrombin Time (INR) Monitors - Coverage Change DMD
How to Avoid PECOS Ordering Physician Denials DMD
Humidifiers - HCPCS Codes E0550, E0555, E0560, E0561, and E0562 DMD
Incorrectly Coded DMEPOS Items to be Denied DMD
Items Provided on a Recurring Basis and Request for Refill Requirements - Revised - August 2012 DMD
KX Modifier Billing Reminder DMD