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Friday, November 6, 2009

NAS DME Update



NAS DME Jurisdiction D E-mail List
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Subscribed Interests
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Mobility Devices

Replacement of Power Mobility Devices Reminder

Suppliers are reminded that replacement of power mobility devices (PMDs) under reasonable useful lifetime rules differ from other types of durable medical equipment.
Power Mobility Devices - 7-Element Order

Medicare national and local policy specify that following completion of the face-to-face examination, the physician or treating practitioner must complete a written order containing seven specified elements. Suppliers have the option of providing physicians with a form that lists the seven elements, but which requires the physician to provide all of the requested information.
Oxygen

CERT Errors - Oxygen

The Comprehensive Error Rate Testing (CERT) contractor has been identifying a significant number of errors on claims for oxygen equipment. Most of the errors are due to insufficient documentation to support the medical necessity for the billed items.
Parenteral / Enteral Nutrition

Enteral Nutrition Supply Kits - Coverage Reminder

Suppliers are reminded that supply kits used for the administration of enteral nutrition must match with the route of administration.
Pharmacy / Infusion

Insulin Pump Qualification: Beta Cell Autoantibody - Coding Reminder

The Centers for Medicare & Medical Services (CMS) national coverage determination for infusion pumps (Internet-only Manual, Pub. 100-03, Chapter 1, Part 4, Section 280.14) and the External Infusion Pump local coverage determination (LCD) contain coverage criteria for continuous subcutaneous insulin infusions using an external insulin pump. Criterion B requires a positive beta cell autoantibody test. Recently the DME MACs have received questions about which tests are acceptable to meet the beta cell autoantibody coverage requirement.
Supplies

Tracheostomy Care Kit - Coding Guidelines

Codes A4625 (Tracheostomy care kit for new tracheostomy) and A4629 (Tracheostomy care kit for established tracheostomy) describe supplies that are used to maintain a tracheostomy tube including the tracheostomy site. The items listed below are essential items that must be included in a tracheostomy care kit but may not be all-inclusive of items that meet the patient's needs. Quantities of items in excess of those listed and/or additional items (e.g. other types of surgical dressings) are included in the kit codes and may not be billed separately. Items included in these codes are not limited to pre-packaged "kits" bundled by manufacturers or distributors.
General Announcements
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Jurisdiction D Happenings, Issue 24, Now Available

Jurisdiction D Happenings, Issue 24, is found on our DME Web site in the News/Publications section in a PDF format. The bulletin contains educational material, claim submission reminders, reimbursement and coverage updates and much more for suppliers in Jurisdiction D. The bulletin also includes a Table of Contents that is both alphabetized and sorted by topic to allow for quick access.
Medicare DMEPOS Rules to Take Effect in 2010

The final rule discusses maintenance and servicing, the grandfathering process, and claims for damages.
Other Topics
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Break in Service and Extending CMNs
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What's New
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View a complete listing of the most recent web site updates: https://www.noridianmedicare.com/dme/news/updates.html

Supplier Contact Center Closures
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    November 20, 2009, from 8 a.m. - 12 p.m. CT for CMS-approved training (Supplier Contact Center only)

Workshops
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Tell NAS where, how, and what topics you want workshops on: http://www.surveymonkey.com/s.aspx?sm=HtqIIW7uv6fE52pDD9bb3w_3d_3d

Medicare Partners
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CBIC: Competitive Bidding Implementation Contractor (Competitive Bidding): http://www.dmecompetitivebid.com/palmetto/cbic.nsf/DocsCat/Home

CEDI: Common Electronic Data Interchange (Electronic Billing): http://www.ngscedi.com/

CERT: Comprehensive Error Rate Testing (Claim Payment Review): http://www.certcdc.com/certproviderportal/pages/

NSC: National Supplier Clearinghouse (Supplier Enrollment): http://www.palmettogba.com/nsc

PDAC: Pricing, Data Analysis and Coding (HCPCS Coding Assistance): https://www.dmepdac.com/

QIC: Qualified Independent Contractor (Reconsiderations): http://www.rivertrustsolutions.com/

RAC: Recovery Audit Contractor (Claim Processing Review): http://www.healthdatainsights.com/

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