BALTIMORE--CMS will continue to give providers some leeway with power mobility claims through the end of the month. In instructions issued Friday to the Durable Medical Equipment Regional Carriers and the new Program Safeguard Contractors, CMS explained that it will not enforce some details of the Interim Final Rule for power mobility devices until April 1.

Under the IFR--which eliminates the certificate of medical necessity and replaces it with a face-to-face exam and a prescription (see HomeCare Monday, Aug. 29, 2005)--physicians are required to provide medical records documenting a patient's medical necessity for a power wheelchair or scooter.

Although the IFR officially took effect Oct. 25, a subsequent congressional directive put federal funds on hold for CMS to implement or enforce the rule before April 1.

While claims must be supported by a face-to-face exam and a written prescription, CMS said in the transmittal issued late Friday afternoon, for claims received between Jan. 1, 2006, and April 1, 2006, DMERCs, Regional Home Health Intermediaries and/or DME PSCs will:

--Not require the details of the written prescription defined in the IFR. The written prescription needs to be signed and dated by the physician or treating practitioner who performed the face-to-face exam.
--Not auto-deny PMD claims when the EY modifier has been used to indicate that the written prescription with the elements specified in the IFR was not received by the DME supplier within 30 days after the face-to-face examination.
--Not require that the written prescription for the PMD be received by the supplier within 30 days after the face-to-face exam.
--Continue to accept the partially completed unsigned CMN and not edit on these partially completed CMNs.
--As defined in the Medicare Program Integrity Manual, if data analysis indicates potentially aberrant billing, DMERCs and/or DME PSCs shall continue to follow [this guidance] when performing medical review on claims.

Last month, CMS announced that physicians and treating practitioners who prescribe PMDs will not receive payment for supplying medical records to HME providers until April (see HomeCare Monday, Feb. 27).

A Medlearn Matters article on the subject will be available by clicking here.