Medical Director Articles - 2022

 
Title Brief Description Last Updated
Correct Coding - Submitting Oxygen Claims with Modifiers KX, GA, GY, and GZ - Revised Oxygen and Oxygen Equipment LCD reminder to suppliers of the proper use of modifiers to indicate whether or not the beneficiary meets the reasonable and necessary requirements in the LCD. 12/29/22
Reminder - Oxygen Qualification Tests and Documentation - Revised Suppliers are reminded that the CMS NCD for Home Use of Oxygen and the DME MAC LCD and Policy Article on oxygen equipment both prohibit supplier involvement in the qualifying test process for home oxygen therapy. 12/22/22
RETIRED - CMS Issues Interim Final Rules with Comment (CMS-1744-IFC & CMS-5531-IFC) - COVID-19 Public Health Emergency - Revised On April 6, 2020, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule with comment (CMS-1744-IFC), establishing that certain requirements for face-to-face/in-person encounters will not apply during the COVID-19 public health emergency. 12/22/22
Video and Transcript Published - Proposed Glucose Monitors LCD (DL33822) Virtual Open Meeting Announcement of the video and transcript from the Glucose Monitor Open Meeting. 12/15/22
RETIRED - HCPCS Codes K1018 and K1019 - Correct Coding - Revised Revised correct coding instructions for K1018 and K1019. 12/01/22
RETIRED - Panzyga® (Immunoglobulin Intravenous (Human), 10%) Correct Coding and Coverage - Revised Update to the correct coding article on Panzyga to include ICD-10 code D81.82 with proper billing instructions. 11/23/22
Billing Instructions - Parenteral and Enteral Nutrition Effective for claims with dates of service on or after January 1, 2023, the DME MAC Information Form (DIF) for Parenteral and Enteral Nutrition is eliminated. 11/17/22
CMN and DIF Elimination - Correct Coding and Billing Effective for claims with dates of service on or after January 1, 2023, claims that are received with CMNs or DIFs attached will be rejected and returned to the supplier. 11/17/22
Open Meeting Agenda - Glucose Monitors Proposed Local Coverage Determination (LCD) This article provides the agenda for the Glucose Monitors Proposed LCD open meeting scheduled for November 15, 2022. 10/31/22
2022 HCPCS Code Update - October Edition - Correct Coding This article identifies revised changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for October 2022 10/27/22
Open Meeting Announcement - Glucose Monitors Proposed Local Coverage Determination (LCD) This article announces an open meeting for the Glucose Monitor LCD. 10/06/22
Proposed Local Coverage Determination (LCD) Released for Comment - Glucose Monitors This article announces the Proposed Local Coverage Determination for Glucose Monitors and that comments may now be submitted. This includes the specific email address for comments and deadlines for those comments to be submitted by. 10/06/22
Basics of Choosing the Correct HCPCS Code - Correct Coding Correct Healthcare Common Procedure Coding System (HCPCS) code selection for a product is an essential element for claims payment. Use of the appropriate HCPCS code assures that accurate processing can be accomplished resulting in a proper claim determination and reimbursement. 09/08/22
2022 HCPCS Code Update - July Edition - Correct Coding This article identifies changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for July 2022. 06/30/22
RETIRED - CMS Issues Interim Final Rules with Comment (CMS-1744- IFC & CMS-5531-IFC) – COVID-19 Public Health Emergency - Revised On April 6, 2020, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule with comment (CMS-1744-IFC), establishing that certain requirements for face-to-face/in-person encounters will not apply during the COVID-19 public health emergency. 06/03/22
Nebulizers - Final LCD and Response to Comments (RTC) Article Published This article announces the final LCD for Nebulizers and the Response to Comment document. 04/21/22
2022 HCPCS Code Update - April Edition - Correct Coding - Revised This article identifies revised changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for April 2022 04/14/22
RETIRED - 2022 HCPCS Code Update - April Edition - Correct Coding This article identifies changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for April 2022. 03/31/22
RETIRED - Code Verification Review Requirement for Lower Limb Orthoses (L1832, L1833, and L1851) and Lumbar Sacral Orthoses (L0648 and L0650) This article provides instructions for PDAC code verification reviews for certain lower limb orthoses devices and lumbar sacral orthoses devices. 03/31/22
RETIRED - Upper Limb Prostheses - Correct Coding The DME MACs and the Pricing, Data Analysis and Coding (PDAC) Contractor want to remind DMEPOS suppliers about the correct coding of upper limb prostheses. 03/31/22
PDAC Code Verification Reviews for CGM Devices - Coding and Billing This article provides instructions for PDAC code verification reviews for CGM devices. 03/17/22
Correct Coding and Billing of Halo Procedure The DME MACs and the Pricing, Data Analysis and Coding (PDAC) Contractor want to remind DMEPOS suppliers about the correct coding and billing for a halo procedure. 03/17/22
RETIRED - Continuous Glucose Monitors - Correct Coding and Billing - Revised This article provides revised correct coding instructions for continuous glucose monitors, both non-adjunctive and adjunctive. 03/17/22
RETIRED - Continuous Glucose Monitors - Correct Coding and Billing This article provides correct coding instructions for continuous glucose monitors, both non-adjunctive and adjunctive. 02/24/22
Irrigation Supply Sleeves - Correct Coding This article provides correct coding instructions for irrigation supple sleeves HCPCS codes A4436 and A4437 which replaces discontinued HCPCS code A4397. 02/10/22
RETIRED - Completion of Certificates of Medical Necessity (CMN) - Annual Reminder Annual reminder regarding the completion of the Certificate of Medical Necessity, commonly known as CMNs, which are documents used by the DME MACs to assist in gathering information about the medical necessity of an item. 01/20/22
Items Provided on a Recurring Basis and Request for Refill Requirements - Annual Reminder - January 2022 Annual reminder for all DMEPOS items and supplies provided on a recurring basis, billing must be based on prospective, not retrospective use. 01/20/22
RETIRED - HCPCS Codes K1018 and K1019 - Correct Coding This article provides correct coding instructions for HCPCS code K1018 and K1019. 01/20/22
Last Updated $dateUtil.getDate( $modifieddate , "MMM dd , yyyy" , $locale , $tzone )