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Preventing Replacement Positive Airway Pressure (PAP) Supply claim denials

By Donna Youngblood RN, BSN, CPC There are many different scenarios for patients requiring replacement PAP supplies. Common scenarios include the need for new supplies during the 13-month rental after initiation of PAP therapy, needing supplies for...

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Proof of Delivery - What do I need to be compliant with Medicare guidelines?

By Kim Turner , RN Although CMS has not made any recent changes to the current proof of delivery (POD) documentation requirements and guidelines for Medicare, it is recommended as best practice to evaluate the procedures you have in place for meeting the...

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Prior Authorization for Group 2 Pressure Reducing Support Surfaces Goes Nationwide October 21, 2019

By Kim Turner, RN Effective for dates of delivery on or after July 22, 2019, Medicare requires prior authorization for Group 2 Pressure Reducing Support Surfaces (PRSS) for the states of California, Indiana, New Jersey, and North Carolina for HCPCS...

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Is Polysomnogram Scoring a concern for you?

By Donna Youngblood RN, BSN, CPC If you are a supplier that dispenses Positive Airway Pressure (PAP) devices and/or supplies then you should be familiar with the Local Coverage Determination (LCD) that includes coverage criteria for PAP therapy. The...

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DME QIC Appeals Update

Effective September 1, 2019, MAXIMUS Federal will serve as the DME QIC for the entire United States and the U.S. territories. This means that any requests for reconsiderations received on or after September 1, 2019 will be processed by MAXIMUS. With...

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How to successfully bill for loaner equipment

By Carrie Nienberg, RN, CPC, Director of Clinical Operations While patient owned DMEPOS is being repaired, you as the supplier may provide a loaner piece of equipment and be paid for the temporary replacement by Medicare, if billed correctly. K0462...

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