Article Detail - JA DME

A new look up tool has been created to help suppliers and billers determine if a specific Healthcare Common Procedure Coding System (HCPCS) code is included in the Round 2021 Competitive Bidding Program. After entering the HCPCS code, in the Competitive Bid HCPCS Lookup Tool, the tool will provide information when the item is included in competitive bid. This tool will also provide guidance on how to identify if a beneficiary's permanent address is in a competitive bid area.

The following information will be displayed when entering a competitive bid HCPCS.

• Utilize the Round 2021 CBA Zip Code Lookup Tool to identify if the beneficiary's permanent address is included in a competitive bid area for the item you are providing.
• Follow the Competitive Bid guidelines provided by the Competitive Bid Implementation Contractor (CBIC)
• Some HCPCS codes require Prior Authorization, Face-to-Face and Written Order Prior to Delivery with dates of service April 13, 2022 and after.

This new tool can be found on the Noridian website Tools webpage.