| Average Medicare DSO (Days Sales Outstanding) By Product Category | DME (E0260, K0001, E0143, etc.) | 60 |
| Respiratory (E1390, J7619, E7619, etc.) | 47 | |
| Rehab (K0011, K0108, E0010, etc.) | 82 |
HCPCS Code B4150
(Enteral Formula)
Average Medicare DSO
92 days
The extensive CMN requirements for enteral formula contribute to its higher than average DSO. A Revised Certification is required for a formula that has been previously certified and if: (1) the number of calories per day changes; (2) the number of days per week administered changes; (3) the method of administration (syringe, gravity, pump) changes; or (4) the route of administration is changed from tube feedings to oral feedings (if billing for denial).
Regularly scheduled recertifications are not required. However, a recertification is required if the physician indicates a length of need of less than lifetime (i.e., less than 99 months) on the CMN and subsequently orders a greater length of need. Recertification also may be requested on an individual basis at the discretion of the Medicare contractors.
The good news is that as of Oct. 1, 2006, the CMN for enteral nutrition is no longer required. Suppliers will be able to complete a DME Information Form and sign the form attesting that the information provided is true, accurate and complete to the best of their knowledge. However, the supplier is still required to get a Detailed Written Order from the physician. As of press time, the information that will be required on the order had not been released. For more details on the new Enteral DIF and Detailed Written Order requirements, see your Medicare contractor's September 2006 bulletin.
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 1.3 million Medicare claims paid between Aug. 1, 2006, and Aug. 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.
