Noridian Healthcare Solutions, the Supplemental Medical Review Contractor (SMRC), has added two new DMEPOS items to their current projects lists: surgical dressings and ostomy supplies.
Noridian will be conducting post-payment review of claims for Medicare Surgical Dressings billed on dates of service from January 1, 2019 through December 31, 2019. This review will include all surgical dressing HCPCS found in the Surgical Dressings Local Coverage Determination (LCD) L33831.
Noridian will also conduct a post-payment review of claims for Medicare ostomy supplies billed on dates of service from January 1, 2019 through December 31, 2019. This review will include all ostomy supply HCPCS found in the Ostomy Supplies Local Coverage Determination (LCD) L33828.
The National Home Health Hospice and DMEPOS Recovery Audit Contractor (RAC), Performant, has also added two new items to their CMS approved issues list: enteral and parenteral nutrition. Both are complex reviews with dates of service on/after September 5, 2021. Affected codes for the enteral nutrition therapy review include: B4034, B4035, B4036, B4081, B4082, B4083, B4087, B4088, B4149, B4150, B4152, B4153, B4154, B4155, B4157, B4158, B4159, B4160, B4161, B4162, B9002. Codes included in the parenteral nutrition therapy review include:B4164, B4168, B4172, B4176, B4178, B4180, B4185, B4189, B4193, B4197, B4199, B4216, B4220, B4222, B4224, B5000, B5100, B5200.
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