| NHIC, Corp.DME MAC A ListServe | For Immediate Release |
February 26, 2009
Supplies and Accessories Used With Beneficiary Owned EquipmentEffective for claims submitted on or after April 1, 2009, for supplies and accessories to be used with beneficiary-owned equipment, all of the following information must be submitted 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.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 of whether the patient owns the equipment that requires the part or supply.Medicare requires that supplies and accessories only be provided for equipment that meets the existing coverage criteria for the base item. In addition, should the supply or accessory have additional, separate criteria, they must be met also. In the event of an audit or claim appeal, suppliers should provide information justifying the medical necessity for the base item and the supplies and/or accessories. Refer to the applicable Local Coverage Determination(s) and related Policy Article(s) for information on the relevant coverage, documentation and coding requirements. |
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