Maintenance and Servicing Update

Original Effective Date: 10/01/2000
Revision Effective Date: 11/01/2013

CIGNA Medicare Region D and the DMERC Advisory Committee (DAC) formed a maintenance and servicing workgroup in October 1999. As a result of this workgroup CIGNA Medicare generated a report listing denied maintenance and servicing (MS) claims. The criteria for this report were:

  • A rental month denied because the rental period had expired, and
  • At least one maintenance and servicing claim was paid, and
  • Subsequent maintenance and servicing claim was denied because 15 rental months had not been paid.

CIGNA Medicare has completed the review of this report and many MS claims have been adjusted for payment.

The following items may cause MS claims to be denied or delayed:

  • MS claims billed before they are due. MS claims should not be billed before 15 rental months have been paid. The first MS claim is payable 180 days from the end of the 15th rental month (90 days for parenteral pumps). Subsequent MS claims should be billed 180 days from the last paid MS claim (90 days for parenteral pumps).
  • MS claims billed with no evidence of rentals. You may receive a letter requesting information regarding the rental of the item and evidence of medical necessity. The information should be returned within 30 days or the claim may be denied.
  • Electronic CMNs transmitted with the MS modifier. Please DO NOT transmit CMNs with the MS modifier appended to the HCPCS code. This may cause an unnecessary denial or delay in claim processing.

If after research, you find an MS claim was denied in error and has not been adjusted for payment, resubmit the claim. The claim must be submitted within the time limits for filing.

Last Updated May 10 , 2017