POE AG Meeting Minutes - April 30, 2025 - JD DME

Attendees

Members: Anna Markiewicz, Bill Noyes, Februari Lester, Jan Palmer, Kimberlie Rogers-Bowers, Kimberly Brason, Maria Sanchez, Michelle Wullstein, Noel Neil, Rhonda Turner, Wayne Bradberry, Yvette Nugent, Yvonne Weiler

Noridian: Amber Mertz, Brenda Swancy, Corinne Medina, Dan Schmitt, Kelsey Slettebak, Shelly Carlson, Tanya Gillies, Tracy Schutt

POEAG Mission and Goals

Mission

To determine the best methods of providing quality education and training to our supplier community.

Goals

• The primary function of POEAG is to help the MAC create, implement, and review provider education strategies and efforts.
• POEAG provides input and feedback on training topics, provider education materials, and dates and locations of provider education workshops and events.
• POEAG also identifies salient supplier education issues and recommends effective ways to disseminate information to all appropriate suppliers and their staff.
• POEAG is a provider education consultant resource but not an approval or sanctioning authority.
  • CMS Internet Only Manual (IOM), Publication 100-09, Chapter 6

Suggestions from POE Advisory Members

• Realigning with IOM direction
• Bring suggestions and feedback to this meeting
  • Policy specific questions:
    • Ask the Contractor Meeting (ACM) - May 21
    • Monday Live Chat
    • Policy specific webinars

Standing Items

• Collaborative MAC education
• A/B DME Workgroup - Surgical Dressings webinar
  • May 6, 2025
• CERT Task Force Surgical Dressings webinar
  • May 8, 2025

Follow-up from Previous Meeting - General

• Supplier complaints due to differences between CGS/Noridian processes
  • None currently

Joint DME MAC Publications posted at Policies > Medical Director Articles > 2025

• Posted January 2, 2025 - Dynamic Adjustable Devices, Static Progressive Stretch Devices, and Use of Modifiers
• Posted February 6, 2025 – New HCPCS Codes for Dynamic Adjustable Joint Stretching Devices – Coding and Billing
• Posted February 13, 2025 - PA revision replacement of supplies for Medicare-paid, beneficiary-owned equipment
• Posted February 27, 2025 - Items Provided on a Recurring Basis and Request for Refill Requirements - Annual Reminder - January 2025 - Revised
• Publication on CR modifier by Judie (add here when it's been posted)
• Posted March 6, 2025 - VYALEV, the VYAFUSER Pump, and Related Infusion Supplies - Correct Coding and Billing - Revised
• Posted March 13, 2025 - New HCPCS Codes for Wheelchair Accessories - Coding and Billing
• Posted March 20, 2025 - PA revision removing language regarding permanent urinary retention not expected to be medically/surgically corrected within 3 months
• Posted April 10, 2025 – Continued Use of Modifier CR and COVID-19 Claim Narrative (Education and Outreach > National DME MAC Education webpage)

New Items

General

• Virtual Events
  • Power Symposium - April 14, 2025
  • NHIA - April 15, 2025
  • PAMS - April 24, 2025
  • MAMES - April 25, 2025
• Ask the Contractor Meeting (ACM)
  • May 21, 2025
  • General - all topics
• Removal of eligibility from Interactive Voice Response (IVR) effective March 3, 2025
• Telehealth services extended through Sept 30, 2025
  •  CMS Telehealth Website
• Immunosuppressive drugs
  • For dates of service (DOS) on/after January 1, 2025
    • Up to a 90-day supply allowed for immunosuppressive drugs
    • Required narrative stating 3-months or 90 days
  • DOS prior to January 1, 2025, supply limited to 30 days
  • New article – "Supply Allowance for Immunosuppressive Drugs"
    • Jurisdiction A
    • Jurisdiction D

DME

• Suppliers requesting more education on proper billing of Continuous Glucose Monitor (CGM) supplies; specifically,
  • When can providers change DOS to match "next billable date" available
  • What DOS should be used when patient does not get additional supplies until after "next billable date" has passed
    • Noridian: The CGM supply is a monthly supply fee code and can be billed every 30 days. Please utilize the Continuous Glucose Monitor (CGM) Supply Allowance Calculator on the Noridian Medicare website to determine when the next supply fee code should be billed. This monthly supply fee code does not follow the refill request that is outlined in the Standard Documentation Requirements A55426.
• Further education will be provided. Watch our Schedule of Events for dates and times.
• Realigning with IOM

Open Discussion/Additional Member Comments/Suggestion

• There is a new code, E0469 (lung expansion airway clearance, continuous high frequency oscillation, and nebulization device) with no policy. Can education be provided to suppliers on what to do if there is not a policy for the item they are providing?
  • We are in the process of drafting an article that will be posted to our website.
• Regarding the new code hydrophilic intermittent urinary catheters, will there be education for DME suppliers and clinicians?
  • Yes. A slide has been added to the upcoming webinar and an article will be posted.

Upcoming Meeting

Next Meeting: July 23, 2025