| Average Medicare DSO (Days Sales Outstanding) By Product Category | DME (E0260, K0001, E0143, etc.) | 63 |
| Respiratory (E1390, J7619, E7619, etc.) | 46 | |
| Rehab (K0011, K0108, E0010, etc.) | 88 |
HCPCS Code E1002
(Power seating system accessory)
Average Medicare DSO
105 days
The E1002, power seating system accessory, has one of the highest DSOs that we have looked at this year. Power mobility has been a hot topic for the HME industry, and with the addition of the face-to-face exam rule and the need for the physician notes to be on file with the supplier, it's not surprising to see the increased DSO.
In addition to the time it takes to gather all of the medical documentation required to prove medical necessity of power wheelchairs and their accessories, another reason why the E1002 payments are delayed is that many providers choose to send these claims to advanced determination to assist them when trying to ensure payment.
Power chair accessory claims require the HAO record to be completed to show medical necessity. If there is not adequate information in that field, the claim will be “developed” (request for more information before a payment determination is made) or just flat out denied, and a redetermination request will be required.
When completing a redetermination request, be sure to send the following documentation: dispensing order, written order, face-to-face evaluation form, physician chart notes, physical therapy evaluation and chart notes detailing the patient's need for the equipment. Chart notes can include but are not limited to: prognosis, diagnosis, patient history, past use of equipment and results, physical examination findings, functional abilities and limitations, etc. For more details, see your region's medical policy manual.
Sarah Hanna is a reimbursement consultant and vice president of ECS Billing & Consulting, Tiffin, Ohio, and specializes in proper billing protocols, Medicare coverage guidelines and billing office procedures. She can be contacted at 419/448-5332 or sarahhanna@bright.net.
Data represents a categorized and weighted analysis of approximately 1.1 million Medicare paid claim lines adjudicated by the four DMERCs between March 1, 2006, and March 31, 2006, and processed for RemitDATA customers. Figures reflect the average number of days elapsed from date of service to Medicare check issue date. Source: RemitDATA, 866/885-2974, www.remitdata.com.
