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| Clarification on Coverage Guidelines for HCPCS E0936 The previous article titled, Clarification on Coverage Guidelines for HCPCS E0936 that was sent via the Jurisdiction B Listserv on January 25, 2010 has been rescinded and is being replaced with the following information. National Government Services, the Jurisdiction B DME MAC would like to remind suppliers of the Medicare coverage on Healthcare Common Procedure Coding System (HCPCS) code E0936 (Continuous passive motion (CPM) exercise device for use other than knee). For suppliers that are dispensing a CPM device that is not used for the knee (E0936), the item would be considered not medically necessary for Medicare coverage. This is based on the national policy in the National Coverage Determinations Manual, Section 280.1 which can be located at: http://www.cms.hhs.gov/manuals/downloads/ncd103c1_Part4.pdf. In order for the beneficiary to be held liable for payment, suppliers must properly execute an Advance Beneficiary Notice of Noncoverage (ABN) prior to dispensing the item to the beneficiary. When an ABN is properly executed, the GA modifier should be appended to the claim line(s). If the supplier is unable to properly execute an ABN prior to dispensing this item, the supplier would bill the claim line(s) with a GZ modifier. The payment liability would be the supplier s not the beneficiary s for the claim line(s) that are billed with the GZ modifier. For additional information on ABNs, please refer to chapter 10 of the Jurisdiction B Supplier Manual at: http://www.ngsmedicare.com/content.aspx?CatID=3&DOCID=235 For additional information on coding, please refer to Chapter 14 of the Jurisdiction B DME MAC Supplier manual at: http://www.ngsmedicare.com/content.aspx?CatID=3&DOCID=239 |
| Registration and playback for the "On Demand" Medicare University 2009 Virtual Convention has been extended by popular demand to March 31, 2010. National Government Services has extended the availability for registration and playback of the 2009 Medicare University Virtual Convention "On Demand" courses through March 31, 2010. For the low cost of $150, you have access to over 60 unique on-demand courses, not offered through Medicare University, at a time that is convenient for you. Plus, you can earn as many as 57 continuing education units! Visit the Course page on the Medicare University 2009 Virtual Convention Web site to view a list of all the on-demand courses. After March 31, 2010 there is no turning back, so register today at www.NGSMEDICARECONVENTION.com 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! National Government Services encourages all Web site users to provide feedback regarding ways to improve our Web site. The ForeSee Results (pop-up) survey is an easy mechanism for providers to use to let us know how we can best serve you. Your comments play a large role in the enhancements that are made to the National Government Services Web site. 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. |
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