Policies - JA DME
L200 Webinars Claim Examples Needed
To provide suppliers with in-depth insight into LCD requirements via claim examples and real life scenarios, Noridian will begin hosting policy specific L200 webinars.
Fax claim examples to 701-433-5957
Provider Outreach and Education
L200 Claim Example ____ Specialty
Policies (LCDs and NCDs)
Documentation Checklists - View documentation checklists provided to assist suppliers in gathering documentation
Local Coverage Determination (LCD) - View Active | Archived/Retired | Future | Proposed LCDs and Policy Articles (PAs) which define coverage criteria, payment rules and documentation that are applied to DMEPOS claims processed by DME MACs
Medical Director Articles - View articles written collaboratively by all DME MAC Medical Directors and organized by year
National Coverage Determination (NCD) - Access national policies granting, limiting or excluding Medicare coverage for a specific medical item or service
Pricing Data Analysis and Coding (PDAC) - The Pricing Data Analysis and Coding (PDAC) contractor is contracted by CMS to assist suppliers and manufacturers in the proper use of the Healthcare Common Procedure Coding System (HCPCS).
Clinician Resource Letters - Access letters that DMEPOS suppliers may provide to clinicians to assist in obtaining required documentation
Clinician's Checklists - View checklists created specifically for clinicians to assist with ensuring that you complete the appropriate documentation needed when you prescribe durable medical equipment prosthetics, orthotics and supplies (DMEPOS) to your Medicare patients.
- CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Sections 110-140
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 20 - DMEPOS
- CMS IOM, Publication 100-08, Medicare Program Integrity Manual, Chapter 5 - Special DME Review Considerations
- CMS Medicare Claim Review Programs: MR, NCCI Edits, MUEs, CERT, and RAC
Last Updated Wed, 30 Jun 2021 15:43:48 +0000
CPT, ADA, and AHA End User License Agreement for Providers
NOTE: Should you have landed here as a result of a search engine (or other) link, be advised that these files contain material that is copyrighted by the American Medical Association. You are forbidden to download the files unless you read, agree to, and abide by the provisions of the copyright statement. Read the copyright statement now and you will be linked back to here.
CPT codes, descriptors and other data only are copyright 2018 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.
Copyright © 2018, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816
Making copies or utilizing the content of the UB-04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of UB-04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association.