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DME MACs share information on proper coding and billing of Pneumatic Compression Devices (PCD)

On October 3, 2024, a joint DME MAC publication was posted to provide guidance on the correct coding and billing of pneumatic compression devices (PCD). The article aslo explains that both the pneumatic compression device LCD and accompanying...

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DME MACs update wheelchair home assessment requirement

On June 13, 2024, a joint DME MAC article was published, advising the DMEPOS supplier community of recent revisions to the Manual Wheelchair Bases policy article.  Effective July 1, 2024, the following statement was REMOVED:  “When...

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DME MACs update wheelchair home assessment requirement

On June 13, 2024, a joint DME MAC article was published, advising the DMEPOS supplier community of recent revisions to the Manual Wheelchair Bases policy article.  Effective July 1, 2024, the following statement was REMOVED:  “When...

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Final Continuous Glucose Monitor (CGM) policy released

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...

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CMS adds 10 codes to F2F/WOPD list

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...

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CMS announces the elimination of CMNS and DIFs

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...

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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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CMS new demonstration project to include Nurse Practitioners as Certifying Physicians for Therapeutic Shoes and Inserts

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...

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CMS ABN form updated

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...

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Continued Need for Supplies

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,...

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