| Average Medicare DSO (Days Sales Outstanding) By Product Category | |
| DME (E0260, K0001, E0143, Etc.) | 62 |
| Respiratory (E1390, J7619, E7619, Etc.) | 50 |
| Rehab (K0011, K0108, E0010, Etc.) | 96 |
HCPCS Code E1161 (Manual adult wheelchair with tilt-in-space)
Average Medicare DSO 138 days
According to Andrea Stark, a reimbursement specialist who spent five years with the Region C DMERC at Palmetto GBA, the high DSO for HCPCS Code E1161 (manual wheelchair with tilt-in-space) could result from confusion on providers' part about the documentation necessary to support these claims. It's possible a company's employees could be spending unnecessary time rounding up paperwork in order to justify the tilt feature. However, explains Stark, the managing member of MiraVista LLC, a Medicare consultancy for DME suppliers and pharmacies in Columbia, S.C., “all this code requires is a certificate of medical necessity (CMN). Prior authorization is not required. There is an allowable for the code, so you don't have to send information on make, model, pricing or invoice amount.” While it is not necessary, she continues, “if providers want to go above and beyond, they may want to include a short narrative as to what condition the patient has that warrants the tilt feature. That is the only difference in this code and the [K0001] code for a standard wheelchair.”
Data represents a categorized and weighted analysis of approximately 845,000 Medicare paid claim lines adjudicated by the four DMERCs between April 1 and April 30, 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
