The latest in DME news, from regulations and guidelines to payer and patient trends.
Hurricane Florence disaster declaration allows CMS to issue a blanket waiver of Section 1135 of the Social Security Act easing documentation requirements on providers. If your community was affected by the Hurricane, please take the time to read the release and check your corresponding DMEMAC websites for more information on how to proceed with replacing equipment for patients who lost their equipment in the hurricane.
Healthcare Updates
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Upcoming events and news to keep you ahead of the curve.
The DMEMACs have clarified the Billing Instruction for billing with the revised “Q” modifiers. Please take note that if the doctor is prescribing a flow rate that does not encompass a full 24 hours an average is not necessary unless there is a volume adjustment involved. Additionally, a section clarifying that the documentation should be in the medical record was added. Please be sure the liter flow rate is available in the medical records.
CGS
https://www.cgsmedicare.com/jb/pubs/news/2018/09/cope9338.html
Noridian
https://med.noridianmedicare.com/web/jadme/policies/dmd-articles/revised-billing-instruction-oxygen-q-modifiers-and-medical-documentation
Best Practices
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Do’s and don’t’s developed to maximize returns and minimize denials.
Are you “following Medicare guidelines” for your Medicare MCO plans? CMS does oversee the MCOs and most do follow the Medicare pay guidelines. Please be sure to check the medical policy guidelines for each MCO you participate with ensure proper documentation and compliance guidelines.