Jurisdiction B News: LCD and Policy Article Revisions Summary

 

LCD and Policy Article Revisions Summary for March 26, 2009 Outlined below is a summary of the principal changes to several DME Local Coverage Determinations (LCDs) and Policy Articles (PAs) that have been revised and posted.  Please review the entire LCD and each related Policy Article for complete information. Ankle-Foot/Knee-Ankle-Foot OrthosesLCDRevision Effective Date:  06/01/2009HCPCS CODES AND MODIFIERS:Added:  KX modifierDeleted: L2770DOCUMENTATION:Added:  Instructions for use of KX modifier with both the base and addition code(s) Policy ArticleRevision Effective Date:  06/01/2009CODING GUIDELINES:Deleted: Code L2035 from the custom-fabricated orthoses listDeleted: Codes K0628 and K0629 from the list used in diabetic foot problems managementAdded: Codes A5512 and A5513 to the list used in diabetic foot problems managementAdded: Code L4392 to list of codes rejected as incorrect coding when billed with initial issue of a base orthosis. Wheelchair Options and AccessoriesPolicy ArticleRevision Effective Date:  01/01/2009 (March Revision)NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:  Corrected: Noncoverage statement for E2230 CODING GUIDELINES:  Deleted:  Codes E0977, E0997-E0999, E2320, and K0099 from list of invalid codes.  These codes have been discontinued. Note: The information contained in this article is only a summary of revisions to LCDs and Policy Articles.  For complete information on any topic, you must review the LCD and/or article.

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! 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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Jurisdiction B News: Last Chance to Register for the Small Supplier ACT

 

National Government Services, the Jurisdiction B Durable Medical Equipment Medicare Administrative Contractor (DME MAC) will conduct a Small Supplier Ask-the-Contractor Teleconference on Tuesday, March 31, 2009 at 2:00 pm (ET). This teleconference is geared towards small suppliers.  A small supplier is defined as having fewer than ten full-time equivalent (FTE) employees. During the teleconference, suppliers will have the opportunity ask the Jurisdiction B DME MAC specific questions concerning billing, Medicare policies and procedures. Registration for the ACT is available online only and must be completed no later than Friday, March 27, 2009.  To register online, click on the following link:http://www.ngsmedicare.com/NGSMedicare/ADC/EventList.aspx?fromdate=3/1/2009&todate=3/31/2009&display=Month&type=public&eventidn=399&view=EventDetails&information_id=545 Necessary dial-in information will be provided once registration is completed.

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! 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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Jurisdiction B News: Request for Refill of Supplies, Accessories & Drugs

 

Beneficiary Request for Refill of Supplies, Accessories & Drugs The Medicare Claims Processing Manual, Chapter 20, Section 200, states: Suppliers/manufacturers may not automatically deliver DMEPOS to beneficiaries unless the beneficiary, physician, or designated representative has requested additional supplies/equipment.  The reason is to assure that the beneficiary actually needs the DMEPOS.  A beneficiary or their caregiver must specifically request refills of repetitive services and/or supplies before a supplier dispenses them.  A supplier may not initiate a refill of an order.  The supplier must not automatically dispense a quantity of supplies on a predetermined regular basis. Furthermore, the Medicare Program Integrity Manual, Chapter 4, Section 4.26.1, states: For DMEPOS products that are supplied as refills to the original order, suppliers must contact the beneficiary prior to dispensing the refill.  Contact with the beneficiary or designee regarding refills should take place no sooner than approximately 7 days prior to the delivery/shipping date. For subsequent deliveries of refills, the supplier should deliver the DMEPOS product no sooner than approximately 5 days prior to the end of usage for the current product. Beneficiaries cannot "authorize" in advance the routine dispensing of DMEPOS items.  Also, because of the time frames specified, the request for subsequent delivery cannot be made at the time of or soon after the current delivery of items.  For example, when a beneficiary receives a supply of glucose test strips, it would not be acceptable for the beneficiary to tell the supplier at that time to deliver a new supply of test strips in 1-3 months. Suppliers should document the request for a refill. This could be documented in a number of ways, including but not limited to, a postcard signed and dated by the beneficiary, written record of phone conversation between the supplier and beneficiary/caregiver, etc.  The documentation must be available on request.

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! 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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Weather Conditions Impacting NAS DME Jurisdiction D Offices

NAS DME Jurisdiction D E-mail List

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General Updates

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Weather Conditions Impacting NAS DME Jurisdiction D Offices

Due to  a  blizzard in Grand Forks, ND, the NAS DME Phone Reopening line will not be available Wednesday, March 25, 2009. The DME Contact Center is also short staffed due to flooding in Fargo, ND. Staff are working on flood preparation and sandbagging efforts. However, the Interactive Voice Recognition (IVR) phone system (877-320-0390) is fully functional and able to provide eligibility, same and similar information, claim status, and other information to assist you.

IVR User Guide: https://www.noridianmedicare.com/dme/contact/docs/ivr_guide.pdf

IVR At a Glance: https://www.noridianmedicare.com/dme/contact/docs/ivr_at_a_glance.pdf

Please contact our office later in the week or early next week to request phone reopenings or speak with a Customer Service Representative. We appreciate your understanding and support.

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CMN and DIF Appeals Cost $1.4 million.

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Tips to Reduce Denials Read More: https://www.noridianmedicare.com/dme/news/docs/2008/10-oct/cmn_dif_denials_cost_suppliers.html

Supplier Manual Chapter 4; CMN and DIF Forms Read More: https://www.noridianmedicare.com/dme/news/manual/chapter4.html

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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    April 10, 2009, in observance of the Good Friday holiday

    April 17, 2009, from 8 a.m. - 12 p.m. CT for CMS-approved training (Contact Center only)

Electronic Billing Questions?

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See the CEDI, National Government Services, Web site at http://www.ngscedi.com/ for resources, FAQs, manuals, and more!

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DME MAC Jurisdiction D States: AK, AZ, CA, HI, ID, IA, KS, MO, MT, NE, NV, ND, OR, SD, UT, WA, WY, American Samoa, Guam, N. Mariana Islands

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DME MAC A News for March 25, 2009 - DME MAC Jurisdiction A Self-Service Tools Now Available

 

NHIC, Corp.DME MAC A ListServe

For Immediate Release

 

March 25, 2009 DME MAC Jurisdiction A Self-Service Tools Now Available DME MAC Jurisdiction A is excited to introduce the new Self-Service Tools section of our Web site. These Self-Service Tools are available to help with common calculations that may be necessary when making billing decisions on Medicare claims. Our current tool set includes:A Claim Filing CalculatorA Redetermination Request CalculatorA Capped Rental 13th Month CalculatorAn Oxygen Rental 36th Month Calculator Please take a moment to visit this new section of our Web site. Additional tools will be available in the future.

 

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DME MAC A News for March 24, 2009 - The March 2009 NSC Newsletter is Now Available

 

NHIC, Corp.DME MAC A ListServe

For Immediate Release

 

March 24, 2009 The March 2009 NSC Newsletter is Now AvailableThe DME MAC Jurisdiction A would like to inform suppliers that the National Supplier Clearinghouse (NSC) has published the March 2009 issue of the NSC Newsletter. This issue features updated accreditation information as well as surety bond requirements for DMEPOS suppliers. You may view this specific issue and other issues by accessing the NSC Web site.

 

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Jurisdiction B News: DMEPOS Supplier Accreditation – Time is Running Out

 

DMEPOS Supplier Accreditation - Time is Running OutDeadline is September 30, 2009 Time is running out for suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) who bill Medicare under Part B to obtain accreditation by the September 30, 2009 deadline or risk having their Medicare Part B billing privileges revoked on October 1, 2009.  A new MLN Matters Special Edition article on this subject is now available.  This article outlines what you need to do if you have not yet complied with the Medicare Program's supplier and quality standards to become accredited.  To view the article on the CMS website, go to:  http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0903.pdf. While the accreditation process takes on average 6-7 months to complete, the process could take as long as 9 months to complete.  Accordingly, DMEPOS suppliers should contact an accreditation organization right away to obtain information about the accreditation process and submit an application. In order to retain or obtain a Medicare Part B billing number, all DMEPOS suppliers (except for exempted professionals and other persons as specified by the Secretary) must comply with the Medicare program's supplier standards and quality standards to become accredited. The accreditation requirement applies to suppliers of durable medical equipment, medical supplies, home dialysis supplies and equipment, therapeutic shoes, parenteral/enteral nutrition, transfusion medicine and prosthetic devices, and prosthetics and orthotics.  Pharmacies, pedorthists, mastectomy fitters, orthopedic fitters/technicians and athletic trainers must also meetthe September 30, 2009 deadline for DMEPOS accreditation. Certain eligible professionals and other persons as specified by the Secretary are exempt from the accreditation requirement.  Further information on the DMEPOS accreditation requirements along with a list of the accreditation organizations and those professionals and other persons exempted from accreditation may be found at the CMS website: http://www.cms.hhs.gov/MedicareProviderSupEnroll/03_DeemedAccreditationOrganizations.asp.

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! 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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