Downsize Those DSOs

HCPCS Code E0143 (Walker, folding, wheeled w/o seat)

Average Medicare DSO 72 days

If you subtract Medicare’s 14-day payment floor, it is taking providers an average of 58 days to submit a clean claim for this item, which ranges in payment from $102.20 to a ceiling of $120.23 based on the current fee schedule. According to Sarah Hanna, vice president of ECS Billing & Consulting Inc., Tiffin, Ohio, medical justification for a folding wheeled walker (E0143) versus a standard folding walker (E0135) could explain why the DSO on this item is high. “Providers should state that the E0143 is required due to weakness of the upper body of the patient that prevents him/her from lifting the walker and placing it back down, which is required for the E0135,” Hanna points out. “This information should be listed on the physician order, then verified and signed by the doctor. The extra verbiage may cause the physician to linger over the walker order rather than just signing it and sending it back. But if this information is not placed on the initial order to the physician and it is received back by the provider, it will then need to be added and returned to the doctor for re-verification and signature. This, of course, results in a longer period of time the claim is on hold until it is ready for billing.”

Data represents a categorized and weighted analysis of approximately 900,000 Medicare paid claim lines adjudicated by the four DMERCs between March 1 and March 31, 2005, 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