Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) - JE Part A
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
To help providers and suppliers gain a better understanding of the roles of billing, coverage, documentation requirements, and medical necessity when providing DMEPOS to Medicare beneficiaries, there are 57 DMEPOS Local Coverage Determinations (LCDs) as well as various other educational opportunities too.
Prior to dispensing any DMEPOS item, suppliers are expected to conduct a thorough intake and assessment to determine if the beneficiary qualifies for the item. There must be an open line of communication between the supplier and the ordering practitioner. Suppliers are trained on coverage criteria for equipment; however, the documentation to support such criteria must be present in the patient's medical record and cannot come from the supplier.
Access the below areas of interest on the JD DME website.
- Clinician's Corner - Gain a better understanding of coverage and coverage and documentation requirements when providing and ordering DMEPOS to Medicare beneficiaries. View or download prescribing checklists which outline what documentation is needed for various DMEPOS items
- Contact Information - Access Noridian JD contact related webpages
- Education and Outreach - Access several educational avenues available via web-based training, partnerships, one-on-one provider training, Ask-the-Contractor Teleconferences, and tutorials
- Jurisdiction Lists - View year specific lists that will assist providers/suppliers in determining which Medicare contractor to bill for certain HCPCS codes
- LCDs and Articles - Access Medicare policy requirements and resources that can be used to assist in claim submission and gathering necessary documentation
- Latest Updates - View the latest Medicare (CMS and Noridian) news articles before they are published in the email list / listserv or bulletin
- Tools - Access various calculators and tools (E.g. Consolidated Billing/SNF/Home Health/Hospice Lookup tool, Clinician Resource letters, Clinician Checklists, Fee Schedule Lookup Tool, Enteral Nutrition Calculator, etc.)
Resources
- CMS DME Center
- CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy, Chapter 15, Section 110
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 20
