 |
| |
| Positive Airway Pressure (PAP) Devices - Supplier FAQ Revised Question 16 of the Positive Airway Pressure (PAP) Devices - Supplier Frequently Asked Questions published December 2008 has been revised. After discussions with the Centers for Medicare & Medicaid Services (CMS), the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have revised previously published information related to the Advance Beneficiary Notice (ABN). The new response to question 16 shall read: 16. Question: Would it be considered use of a blanket Advance Beneficiary Notice (ABN) to have all new PAP patients sign an ABN at the beginning of therapy stating that if they do not get a face-to-face evaluation or refuse to get the follow-up re-examination by their treating physician between the 31st and 91st day that Medicare will deny the claim? Answer: Yes, it would be considered a "blanket" ABN if the notice was presented at the beginning of therapy. The supplier may however, after day 60 following the dispensing of the PAP device, present an ABN to the beneficiary if the supplier has knowledge that the beneficiary has not yet met the policy criteria for continued coverage. This ABN should advise the beneficiary that if, by the 90th day of therapy, they do not meet the policy criteria for continue coverage (e.g., adherent to therapy and obtain a follow-up face to face evaluation), Medicare may deny their subsequent claim(s) and that the beneficiary will be liable for payment. This new guidance regarding a blanket ABN is effective for claims with initial dates of service on or after July 1, 2009. Advance beneficiary notices executed under the prior instructions contained in the December 2008 FAQ will still be considered valid until the July 1, 2009 effective date of this new instruction. |
| Remember! National Government Services' Jurisdiction B DME MAC List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you! CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message. To unsubscribe/change profile: click here. |
Email list management powered by http://MailerMailer.com
Posts
