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CMS Updates to Lists Related to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Conditions of Payment [CMS-6081-N]

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...

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FDA releases safety information related to the Philips recall

On June 30, 2021, the U.S. Food and Drug Administration (FDA) published a safety communication to their website. The FDA communication urges patients using the affected devices to talk to their health care providers to determine a suitable treatment...

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Acceptable Testing for NIV patients (updated 6/8/2021)

Carrie Nienberg, RN, CPC, Director of Clinical Operations On August 25th, 2020, CGS conducted a webinar on the National Coverage Determination (NCD) coverage criteria and documentation requirements for ventilators. During the webinar, the following...

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CMS removes vents from Competitive Bidding 2021

Just announced, CMS has removed the non-invasive ventilators (NIV) product category from Round 2021 of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program in response to the novel COVID-19 pandemic....

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CMS allows multi-function vent for upgrade

By Carrie Nienberg, RN, Director of Clinical Operations Effective immediately, you as a supplier may provide and bill E0467, multi-function ventilator, as an upgrade when the beneficiary only qualifies for the ventilator. Until now, the beneficiary...

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Next Round of Competitive Bidding Program to Kick Off in 2021...with NIV and OTS orthotics included

On Thursday, March 7, 2019, CMS published a post to their blog providing DMEPOS Suppliers a glimpse into what to expect for the next round of Competitive Bidding. The DMEPOS Competitive Bidding Program was implemented on January 1, 2011. The Round 1...

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Multi-Function Ventilator is Billable 1/1/2019. Can you meet coverage criteria?

By Carrie Nienberg, RN, CPC, Director of Clinical Operations Effective January 1st, 2019, E0467 can be billed to Medicare for reimbursement. An E0467 is defined as "a home ventilator, multi-function respiratory device, also performs any or all of...

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Deadline extended for comments to add Vents and OTS Orthotics to next round of CBP

On November 5, 2018,  CMS posted the call for public comments regarding the potential for ventilators and off-the-shelf back and knee braces to be phased-in for the next round of the DMEPOS Competitive Bidding Program. Per the CMS website:  The...

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OIG Announces Noninvasive Home Ventilators Audits and Onsite Visits

The Office of Inspector General (OIG) has added noninvasive home ventilators to their active work plan items. Recently announced on the 'Active Work Plan Items' list, the audit details are as follows: For items such as noninvasive home ventilators (NHVs)...

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