O&P ACT Questions and Answers - August 21, 2018

Questions Received Prior to ACT meeting

N/A this round

Questions During the ACT

Q1. If therapeutic shoes for persons with diabetes are being provided to a below the knee amputee beneficiary, would Medicare cover both shoes?
A1. Yes, per the Therapeutic Shoes for Persons with Diabetes (TSPD) Policy Article (A52501) "one pair" of shoes will be covered for beneficiaries meeting the coverage criteria.

Q2. Can the HCPCS L2755 be used for high-strength lamination and custom inserts?
A2. It is recommended that suppliers visit the Pricing, Data Analysis and Coding Contractor (PDAC) website for coding information.


  • Medicare Beneficiary Identifier (MBI)
    • Use of MBI began April 1, 2018
    • Suppliers may submit with either Health Insurance Claim Number (HICN) or MBI between April 1, 2018 and December 31, 2019
    • Beginning October 2018 claims submitted with HICN will be returned with both HICN and MBI
    • January 1, 2020, MBI must be used for claim submission
    • Suggest adding questions to your intake process
    • Have you received a new Medicare card?
    • Did you know that Medicare is sending out new cards to their beneficiaries?
  • Targeted Probe and Educate (TPE) results
    • Results are now posted on the Noridian website to allow suppliers to follow the status of product categories that they provide
  • Monday Live Chat
    • Occurs every Monday at 2 p.m. CT
    • 30-minute time limit
    • Open forum for both written and verbal questions
    • General questions only - NO claim specific questions
  • We're on YouTube!
    • Noridian home page on the website will take suppliers right to the tutorials we have posted
  • Electronic supplier visits
    • Free consultation with Provider Outreach and Education
    • Encourage referrals to attend
    • Schedule one today by visiting the Forms tab of the Noridian website and selecting "Individualized Education Request"
  • Noridian Medicare Portal
    • If you have not already registered you will want to add this tool for your business success
    • Access eligibility, claim status, submit reopenings, appeals and much more
  • Register for the ListServ!
    • All latest updates
    • Can customize by specialty
    • Stay informed
  • Webinars
    • Be sure to take advantage of L200 webinars
    • More advanced
    • Scenario based
    • Errors identified, corrections shared, prevention education provided

Resources and Reminders

  • Overview of Comprehensive Error Rate Testing (CERT) error rate for projected 2017 improper payment rates
  • Recovery Audit Contractor (RAC) overpayments may be completed as written reopenings
  • Effective March 1, 2018
  • Please take advantage of DME on Demand
  • Available 24/7
  • Use the Noridian website to take full advantage of resources available
  • Advantages of Electronic Funds Transfer (EFT)
  • How to set your business up for Electronic Remittance Advices (ERAs) and EFT

Next Call


Last Updated Sep 17, 2018