| Average Medicare DSO (Days Sales Outstanding) By Product Category | DME (E0260, K0001, E0143, Etc.) | 60 |
| Respiratory (E1390, J7619, E7619, Etc.) | 89 | |
| Rehab (K0011, K0108, E0010, Etc.) | 48 |
HCPCS Code E0601 (Continuous Positive Airway Pressure Device)
Average Medicare DSO 52 days
Even though a CPAP claim no longer requires a certificate of medical necessity for reimbursement, the high DSO for this code could be attributed to the documentation required to show patient compliance with the device. “It makes sense that it would be delayed at the provider's office after three months of billing because follow-up documentation must be obtained on the patient's compliance. Providers cannot bill until this documentation is in house,” according to Andrea Stark, a reimbursement specialist and managing member of Columbia, S.C.-based MiraVista LLC (www.miravistallc.com), a Medicare consultancy for DME suppliers and pharmacies. “Secondly, this code requires the use of a KX modifier in order to signify that specific qualifying documents are on file at the provider's office,” continues Stark, who previously spent five years with the Region C DMERC. If the modifier is left off, the only way to correct it is through a telephone or written review. That will obviously delay the payment for this procedure code.” Providers are advised to make certain that they understand the modifiers and use them correctly before they are added.
Data represents a categorized and weighted analysis of approximately 925,000 Medicare paid claim lines adjudicated by the four DMERCs between June 1 and June 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
