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The van Halem Group Announces New Partnership with Össur Americas, Inc.

The van Halem Group will be partnering with Össur Americas, Inc., a global manufacturer of orthotic and prosthetic products. As part of this agreement, The van Halem Group will provide clinical prescreen reviews and appeal services for custom orthotics...

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Changes to billing DMEPOS

By Kim Turner In a change release (CR) dated 12/20/2019 regarding MLN Matters MM11554, CMS published the following information on where to bill DMEPOS and PEN services. Effective date March 23, 2020, suppliers enrolled with the National Supplier...

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CMS adds LLP codes to the Prior Authorization List

On February 11, 2020 CMS will publish updates to the Federal Register, inlcuding the addition of six new codes to the prior authorization list. The Prior Authorization List includes DMEPOS items that require prior authorization as a condition of payment....

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Hospital Beds and Manual Wheelchairs added to RAC Approved Issues

CMS has approved two new topics for the DMEPOS RAC, Performant, to begin reviewing, effective March 1, 2020. Hospital Beds: Medical Necessity and Documentation Requirements Description: Hospital Beds must meet basic coverage criteria whether at...

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CMNs and ABNs are nearing expiration...what do you do?

By Carrie Nienberg, RN Clinical Director CMNs for Oxygen, Pneumatic Compression Devices, Osteogenesis Stimulators, Transcutaneous Electrical Nerve Stimulator (TENS), Seat Lift Mechanisms, External Infusion Pumps, Enteral and Parenteral nutrition,...

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SMRC To Perform Data Analysis and Reviews of Oxygen and Oxygen Equipment During Noncovered SNF Stays

By Sandra Gauron, Appeals Coordinator Pursuant to the Office of the Inspector General (OIG) report (OEI 06-16-00380), in which the OIG identified potential inappropriate payments to DME suppliers during non-covered SNF stays, CMS has tasked the SMRC...

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