DME MAC Jurisdiction C NewsTemporary Holding of all Diabetes Self Management Training (DSMT) Claims
Medicare Part B covers 10 hours of initial training for a beneficiary who has been diagnosed with diabetes, and beneficiaries are eligible to receive 2 hours of follow-up training each calendar year following the year in which they were certified as requiring initial training. DSMT must be ordered by the physician or qualified non-physician practitioner who is managing the beneficiary's diabetic condition. It is CMS' understanding that many claims that are being submitted as per this policy are incorrectly being edited as if the beneficiary exhausted their 10 hours prior to the initial 12-month period. Until April 6, 2009, if your patient still has initial hours for diabetes training and they are within the initial 12-month period, you may submit a claim that includes all other services besides DSMT services to prevent the claim from being held.
Until CMS corrects the system, any claims that are returned to the provider for DSMT services performed on or after July 1, 2007, where the initial training totals less than 10-hours within the initial 12-month period, these claims can be held until the successful implementation of the April 2009 System Release.
Oxygen Webinars: Are you a supplier who supplies oxygen and oxygen equipment to Medicare beneficiaries? Would you like clarification of the coverage guidelines and an explanation of the recent payment changes for oxygen and oxygen equipment? If you answered "Yes!" to these questions then we have a Webinar for you! The Jurisdiction C DME MAC Provider Outreach and Education team is pleased to offer additional Oxygen Webinars in April. Read more...
http://www.cignagovernmentservices.com/jc/pubs/news/2009/0409/cope9608.html
http://www.cignagovernmentservices.com/jc/pubs/news/2009/0409/cope9608.html
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