Article Detail - JD DME
RETIRED - Billing Reminder: Narrative Requirements for Supplies and Accessories Used with Beneficiary Owned Equipment
Revised March 04, 2011
Posted May 14, 2010
Suppliers are reminded that additional documentation is required in situations where supplies and accessories are provided for a piece of equipment not paid for by Fee-For- Service (FFS) Medicare. In addition, drugs used with a nebulizer or external infusion pump would be considered supplies to a covered piece of DME and must meet the same documentation requirements outlined below.
For supplies and accessories used with equipment purchased privately or by another insurer, all of the following information must be submitted with each claim in Item 19 on the CMS-1500 claim form or in the NTE segment for electronic claims:
- HCPCS code of base equipment; and
- A notation that this equipment is beneficiary-owned; and
- Date the patient obtained the equipment (Month and Year at a minimum)
Example narrative for nebulizer drugs and supplies used with a beneficiary owned nebulizer:
BENEFICIARY OWNED E0570 PURCHASED MAY 2007
Example narrative for CPAP supplies for a beneficiary owned CPAP:
BENEFICIARY OWNED E0601 PURCHASED JUNE 2005
Claims for supplies and accessories must include all three pieces of information listed above. Claims lacking any one of the above elements will be denied for missing information.
Claims denied for missing information on the base piece of equipment may be submitted to written reopenings with the required documentation. If a claim for the base piece of equipment was subsequently submitted after the claim for the supplies and/or accessories denied; the claim can be correct via the telephone reopenings process.
Suppliers can verify payment or record of the base piece of equipment by accessing the CMN Status Option 3 in the Interactive Voice Response (IVR) System. An IVR User Guide is available to assist in this process.
Additional information is available in the April 2009 Medical Review Bulletin titled, "Supplies and Accessories Used With Beneficiary Owned Equipment April 2009 Clarification."
Important Clarification: This documentation must be present on every claim (not only the 1st claim) for supplies and accessories used with beneficiary owned equipment which was not paid for by FFS Medicare.
|Date of Change||Description|
|03/18/2021||Retired due to publishing a revised duplicative article. See article titled Supplies and Accessories Used with Beneficiary Owned Equipment|
Last Updated Thu, 18 Mar 2021 16:41:06 +0000