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Oxygen
Payment for Repair, Maintenance and Servicing of Oxygen Equipment MLN Matters 6296
CMS is providing instructions regarding repair, maintenance, and servicing of oxygen equipment resulting from implementation of Section 144(b) of the MIPPA. The 36-month cap noted in MIPPA applies to stationary and portable oxygen equipment furnished on or after January 1, 2006. Therefore, the 36-month cap may end as early as January 1, 2009, for beneficiaries using oxygen equipment on a continuous basis since January 1, 2006.
Oxygen - Certificates of Medical Necessity - Replacement Equipment
On January 1, 2009, CMS implemented statutory provisions defining a new payment policy for home oxygen. Payment for oxygen equipment is now made for a 36-month rental period. The supplier retains title to the equipment at the end of this rental period but is required to continue to provide the oxygen equipment and contents (when applicable) for the duration of the 5-year reasonable useful lifetime (RUL) of the oxygen equipment. Multiple recent publications have addressed the details of the new payment policy. This article addresses the use of the Oxygen Certificate of Medical Necessity (CMN) in processing oxygen claims.
General Announcements
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Implementation of New Provider Authentication Requirements for Medicare Contractor Provider Telephone and Written Inquiries - Revised MLN Matters 6139
Effective April 6, 2009, when you call either the IVR system, or a CSR, CMS will require you to provide three data elements for authentication: 1) Your National Provider Identifier (NPI); 2) Your Provider Transaction Access Number (PTAN); and 3) The last 5-digits of your tax identification number (TIN).
Supplies and Accessories Used With Beneficiary Owned Equipment
Effective for claims submitted on or after April 1, 2009, for supplies and accessories used with beneficiary-owned equipment, a list of information that must be submitted in Item 19 on the CMS-1500 claim form or in the NTE segment for electronic claims is provided.
Repair Labor Billing and Payment Policy
Effective for dates of service on or after April 1, 2009, the DME MACs are instituting a billing and payment policy for common repairs based on standardized labor times. This applies to non-rented and out-of-warranty items. Code E1340 is no longer valid for repairs for dates of service on or after April 1, 2009.
Remittance Advice Remark Code and Claim Adjustment Reason Code Update MLN Matters 6336
CR 6336 announces the latest update of Remittance Advice Remark Codes (RARCs) and Claim Adjustment Reason Codes (CARCs), effective April 1, 2009 for Medicare. Be sure billing staff are aware of these changes.
April 2009 Quarterly ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files MLN Matters 6380
This article is based on CR 6380, which informs Medicare contractors that on or after December 16, 2008, the January 2009 Average Sales Price (ASP) files will be available for download along with revisions to prior ASP payment files, if CMS determines that revisions to these prior files are necessary. In addition, on or after March 16, 2009, the April 2009 ASP NOC files will be available for retrieval from the CMS ASP webpage along with revisions to prior ASP NOC files, if CMS determines that revisions to these prior files are necessary.
Revised January 2009 - Medicare Fraud and Abuse Fact Sheet
Bill NDC Code for Oral Anticancer Drugs - Reminder
Suppliers are reminded that when billing oral anticancer drugs that only the National Drug Code (NDC) must be reported on the claim, rather than the corresponding HCPCS code or other code identifiers.
DMEPOS Supplier Accreditation - Get it Now
CMS wants to remind suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) who bill Medicare under Part B that they must obtain accreditation by September 30, 2009.
Other Topics
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Electronic Data Interchange
VMS Modifications to Implement CEDI System, Final Implementation MLN Matters 6357
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