External Infusion Pumps - Noridian

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External Infusion Pumps

Coverage

External Infusion Pump Local Coverage Determination (LCD) and Policy Article [PDF]

Documentation

Clinician Letter - Medical Records [PDF] - Letter may be sent to clinicians to help obtain documentation
CMS 10125 DIF [PDF] - External Infusion Pump DME Information Form (DIF)
External Infusion Pump Documentation Checklist [PDF] - Checklist to ensure suppliers gather all required documentation

Reviews/Audits

Medical Review - View notifications/findings of pre/post claim reviews completed by Noridian Medical Review

Tips

Topic	Details
Drugs Used With External Infusion Pumps	Coverage of drugs used with external infusion pumps may have differing denials. It is important for suppliers of these drugs to understand issues related to coverage and denials

Last Updated Aug 20, 2018

Related Articles

The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.

Correct Coding - U 500 Insulin for Use in External Insulin Infusion Pumps Dec 06, 2018

Temporary Transitional Payment for HIT Services for CYs 2019 and 2020 CR10836 Nov 05, 2018

External Infusion Pump Drug Calculator - Now Available Dec 29, 2017

External Infusion Pumps (HCPCS E0784) Notification of Service Specific Prepayment Probe Review May 22, 2017

Correct Coding - JW Modifier Use - Revised - Effective for Claims with Dates of Service On or After January 1, 2017 DMD Jun 16, 2016

Correct Coding - JW Modifier Use - Effective for Claims with Dates of Service On or After July 1, 2016 DMD May 19, 2016

Billing for External Infusion Pumps and Drugs When Treatment Was Initiated Somewhere Other Than the Beneficiary’s Home DMD May 05, 2016

RETIRED - Correct Coding Reminder - Duopa (AbbVie) DMD Apr 28, 2016

Coverage and Correct Coding of YONDELIS DMD Jan 07, 2016

RETIRED - Coverage and Correct Coding of Duopa (Levodopa-Carbidopa Enteral Suspension) - Revised DMD Jan 07, 2016

Updated External Infusion Pump Policy - Parenteral Inotropic Therapy FAQs DMD Oct 15, 2015

Billing Instructions - Completing External Infusion Pump LCD DIF for Levodopa-Carbidopa Enteral Suspension DMD Oct 15, 2015

External Infusion Pump - Response to Comment Summary DMD Oct 01, 2015

Draft Policies Release for Comment Bulletin Article DMD Jul 16, 2015