Category
March 6, 2023 Blood Glucose Monitors and Supplies Compliance DME Documentation Medicare released the final draft of the new Glucose Monitor LCD and Policy Article with an effective date of 4/16/2023. The change was completed after a response to comments for the LCD. This new policy revamps the current CGM coverage criteria with... January 19, 2023 On January 17, 2023, CMS published the annual list of items that require a face-to-face encounter and written order prior to delivery (WOPD). The published list includes 10 additional orthoses codes that will require a require a face-to-face encounter... May 5, 2022 In the weekly CMS MLN Newsletter published Thursday, May 5, 2022, CMS announced,
“Suppliers, billers, and vendors: Certificates of medical necessity (CMNs) and the durable medical equipment (DME) information forms (DIFs) are discontinued... February 1, 2022 DME Documentation Orthotics Respiratory Ventilators Wheelchairs By Donna Youngblood, RN, Clinical Consultant at The van Halem Group
CMS released its long awaited Master List on January 12, 2022 with new codes being added to both the Master list and Required List. In addition, they have added Power Operated Vehicles... November 12, 2020 Effective January 1, 2021 and extending through December 31, 2025, CMS is exercising its authority to allow nurse practitioners to certify that an order for diabetic shoes is required under a new model demonstration for certain states.
Under this... June 29, 2020 CMS has updated the Advance Beneficiary Notice of Noncoverage (ABN) (Form CMS-R-131). Providers can use the new form now, and mandatory use of the form will be on 8/31/2020. The form is valid through 06/30/2023. On or after 8/31/2020, issuing an ABN... June 15, 2020 By Carrie Nienberg, RN, Director of Clinical Operations
Did you know ongoing continued need isn’t required for urological or ostomy supplies?
In the ostomy policy article, under continued need it indicates once initial medical need is established,... May 15, 2020 On May 14, 2020 a Joint DME MAC Bulletin Article was published to provide guidance on use of the KX modifier. Use of the KX modifier indicates that specific required documentation is on file in the patient's medical record. CMS' final rule, which was... March 23, 2020 On Friday the DME MACs provided the following update regarding signature guidelines and proof of delivery:
CMS is currently reviewing signature guidelines that have been affected by the COVID-19 pandemic. At this time suppliers should do their... March 17, 2020 By Carrie Nienberg, RN, Director of Clinical Operations
Currently, Policy Article A52498, revised on 01/01/20, indicates a face-to-face encounter must occur within six months prior to the order date on the Standard Written Order (SWO). If the beneficiary...