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| Billing Reminder - Replacement Oxygen EquipmentRA Modifier National Government Services, the Jurisdiction B Durable Medical Equipment Medicare Administrative Contractor (DME MAC) has identified an erroneous trend in billing for replacement oxygen equipment. Claims for replacement oxygen equipment are being submitted with the RA modifier appended to the initial claim and all subsequent claims for the new 36-month rental period. Appending the RA modifer on all subsequent claims will result in the delay of processing due to the need for a manual review. When submitting a claim for replacement oxygen equipment due to the original oxygen equipment meeting its reasonable useful lifetime, the first months rental claim for the replacement equipment is the only claim that must be billed using the HCPCS code for the new equipment, the rental modifier RR and the replacement modifier RA. In addition to coding the initial claim correctly, the claim must also include a narrative reason for the replacement of the oxygen equipment and the date the beneficiary received the original oxygen equipment. Suppliers are reminded that a written order is required when replacing equipment. Note: The subsequent claims for the replacement oxygen equipment should only have the RR modifier appended. For claims submitted electronically, the required narrative explanation must be entered in loop 2400 (line note), segment NTE02 (NTE01=ADD) of the ANSI X12, version 4010A1 837 transaction. If billing using CMS-1500 paper claim form, the required narrative must be reported in Item 19 of the claim form. The following information should be included in the narrative explanation: The abbreviation RUL which indicates reasonable useful lifetimeDate the beneficiary received the original equipment being replaced (MMDDYY) Example: For additional information regarding the coverage and documentation requirements for oxygen and oxygen equipment please review the Local Coverage Determination and Policy Article for Oxygen and Oxygen Equipment located on the National Government Services Web site at www.NGSMedicare.com. Once you are in the DME Portal pages click on the Coverage Link and then select Local Coverage Determinations. |
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