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Administration announces regulatory changes in response to COVID-19

On March 30, 2020 it was announced that the Trump Administration has continued to make regulatory changes to better address the COVID-19 pandemic. Many of the changes will affect the way DMEPOS suppliers conduct business, including eliminating several...

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Medicare to revise guidelines for L3960

By Kim Turner, RN, Clinical Consultant The HCPCS L3960 is defined as a prefabricated shoulder "airplane design" abduction orthosis which includes the elbow wrist hand and fingers. There are adjustable rigid cuffs and joints/components to optimize...

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COVID19: Billing Medicare Part B Drugs to DME MACs and the CR modifier

By Kim Turner, RN, Clinical Consultant CMS has recently published guidelines for billing of Part B Drugs to DME MACs During COVID-19 Pandemic. During the pandemic, the beneficiary will be allowed to obtain amounts of Part B drugs in excess of the...

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CMS releases COVID-19 Provider Enrollment FAQs

On Sunday, March 22, 2020, CMS released Frequently Asked Questions (FAQs) on Medicare Provider Enrollment Relief related to COV-19. We've highlighted the FAQs specific to DMEPOS Suppliers below. To view the complete list of FAQs, click here. How...

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CMS taking actions in response to COVID-19 national emergency

As our country continues to respond to the 2019 Novel Coronavirus Disease (COVID-19), CMS has taken aggressive action to ensure Medicare and Medicaid beneficiaries are receiving necessary and prompt care. On March 13, 2020, The Trump Administration announced...

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Performant (RAC Region 5) Halts Auditing During the Covid-19 Emergency

By Sandra Gauron, Appeals Coordinator It was confirmed today that Performant will be following CMS’s guidance during the Covid-19 emergency and will not be sending out any new Additional Documentation Request (ADR) letters for 30 days beginning...

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Quick Tip: Proof of Delivery Signature Guidelines during the COVID-19 pandemic

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...

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Relaxed HIPAA requirements for telehealth encounters during the COVID-19 national emergency

On March 13, 2020, the Trump Administration announced regulatory flexibilities to help healthcare providers and states to respond to and contain the spread of coronavirus. Included in the announcement was that CMS will activate blanket waivers in an...

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New guidance on timing of the 6-month face-to-face encounter and Standard Written Order for PMDs

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...

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Avoiding CERT Errors: Tips for ensuring compliance when billing Medicare for a lumbar spinal orthosis (LSO)

By Kim Turner, RN, Clinical Consultant Medicare coverage requires that the LSO is rigid or semi-rigid to support a weak or deformed body member or restricting or eliminating motion in a diseased or injured part of the body. There are three types...

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