Policies (LCDs and NCDs)
Documentation Checklists - View documentation checklists provided to assist suppliers in gathering documentation
Local Coverage Determination (LCD) - View locally hosted LCDs and Policy Articles (PAs) which define coverage criteria, payment rules and documentation that are applied to DMEPOS claims processed by DME MACs
National Coverage Determination (NCD) - Access national policies granting, limiting or excluding Medicare coverage for a specific medical item or service.
Physician Resource Letters - DME suppliers may provide these letters to physicians to assist in obtaining required documentation
- 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 Apr 19, 2017
CPT and ADA End User License Agreement for Providers
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CPT codes, descriptors and other data only are copyright 2016 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.
Last Updated May 16, 2017