WASHINGTON— In what was called a "big win" by the American Association for Homecare (AAHomecare) the Centers for Medicare & Medicaid Services (CMS) published a change request (CR) directing DME MACs to adjust their local edits to allow for 90-day billing for continuous glucose monitor (CGM) supplies to align with blood glucose monitor supplies.
The durable medical equipment Medicare administrative contractors (DME MACs) released the updated local coverage determinations (LCD) and policy article (PA) for glucose monitors, that finalizes expanded coverage for continuous glucose monitors (CGMs).
Durable medical equipment (DME) Medicare administrative contractors (MACs) published updated frequently asked questions (FAQs) relating to the new Oxygen and Oxygen Equipment Local Coverage Determination (LCD) in early February.
WASHINGTON, D.C. (April 27, 2018)—CMS issued guidance titled "Billing Instruction—Oxygen CMN Question 5" on February 15, 2018, requiring suppliers to obtain revised oxygen CMNs for all patients that had different liter flows of oxygen in a 24-hour period effective April 1, 2018. The guidance required the industry to tell prescribers to not answer Question 5 of the CMN as stated on the form.
FARGO, N.D. (July 20, 2017)—Last week, AAHomecare hosted an educational session for DME MAC and PDAC personnel in Fargo, North Dakota, on manual, power and CRT wheelchairs and accessories. Kim Brummett, AAHomecare’s vice president of regulatory affairs, and representatives from member companies who manufacture mobility products were on hand to demonstrate equipment and accessories to approximately 35 individuals involved in audits, coding and claims analysis.
—Via AAHomecare, WASHINGTON, D.C. (May 10, 2017)—On Monday, CGS, the DME MAC Jurisdiction C and B contractor announced that they are prepared to begin reprocessing claims that are subject to the CURES-mandated fee schedule adjustment. The mass adjustments will be conducted in batches. They will be processing claims five days a week and it is expected to take 24 weeks to complete. Jurisdiction C has approximately 4.7 million claims and is planning to reprocess 40,000 claims per day.
WASHINGTON, D.C. (February 13, 2017)—CMS released last week guidance to the DME MACs for retroactive reimbursement adjustments for rural/non-bid area providers for equipment and services furnished between July 1–December 31, 2016. These adjustments follow provisions in last year’s CURES legislation providing a measure of relief for rural/non-bid area providers.
WASHINGTON, D.C. (May 24, 2016)—All four DME MACs recently issued clarification on WOPD requirements as defined in the Affordable Care Act (ACA). AAHomecare has had several meetings with CMS regarding the ACA requirements and how the WOPD does not have to be the DWOPD (detailed written order prior to delivery). You can find the clarification here. This link is to the NHIC website—however, you can find the same information on all four DME MAC websites.
