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Mike Feldman
PCSolutions
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| NHIC, Corp.DME MAC A ListServe | For Immediate Release |
| April 21, 2009 Supplies and Accessories Used With Beneficiary Owned Equipment April 2009 Clarification The DME MACs recently published an article addressing documentation requirements for supplies and accessories used with beneficiary owned equipment. This article only addressed equipment that was not paid for by Medicare FFS - i.e., only equipment that was paid by other insurance or by the beneficiary. For supplies and accessories used with that equipment, all of the following information must be submitted with the initial claim 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. Medicare requires that supplies and accessories only be provided for equipment that meets the existing coverage criteria for the base item. In addition, if the supply or accessory has additional, separate criteria, these must also be met. In the event of a documentation request from the contractor or a redetermination request, 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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