| Average Medicare DSO (Days Sales Outstanding) By Product Category | DME (E0260, K0001, E0143, etc.) | 58.5 |
| Respiratory (E1390, J7619, E7619, etc.) | 44.8 | |
| Rehab (K0011, K0108, E0010, etc.) | 78.7 |
HCPCS Code E0277
(Powered Pressure-Reducing Air Mattress)
Average Medicare DSO
65 days
The powered pressure-reducing air mattress requires a Written Order Prior to Delivery. The WOPD must contain, at a minimum, the following: 1) the patient's full name, 2) a description of the item, 3) length of need, 4) expected start date and 5) the physician's signature and signature date.
Medicare does supply providers with a form, called the Statement of Ordering Physician Group 2 Support Surfaces, that can be used as the Detailed Written Order and the WOPD.
Whether you use the Medicare suggested form or one of your own that emulates the Medicare Statement for Group 2 Surfaces, be aware that any questions pertaining to medical necessity on the forms cannot be completed by the supplier or anyone in a financial relationship with the supplier.
As for modifier issues that may cause a denial and an increase in DSO, the E0277 does require the KX modifier. If you do not attach this modifier, your claim will receive a CO50 denial for lack of medical necessity. You will then have 120 days to file the appeal with your MAC's redetermination department. Be sure to review the local coverage determination for the E0277's coverage criteria in the medical policy section to ensure that your patients meet the medical necessity guidelines, and that all appropriate medical documentation is in place in case of a post-pay audit.
Data represents a categorized and weighted analysis of approximately 1.15 million Medicare paid claim lines adjudicated by the DMERCs and DME MACs between July 1, 2006, and July 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.
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.
