Claims/Billing
• Provider must submit claims in accordance with the Healthcare Common Procedure Coding System (HCPCS) and national industry standards.
• Providers can only bill for the actual number of medically necessary units dispensed/delivered to a recipient, regardless of the number of units allowed by policy and/or prior authorization.
• Providers must bill their usual and customary charges.
Rental Items
Rates identified in the DMEPOS Fee Schedule for rental items (modifier code RR) are calculated as a monthly rate and are to be billed at monthly intervals beginning with the date item was dispensed/delivered to recipient. The exceptions to this are for codes E0202 and E0935, which are daily rates.
Special Instructions for Common Products and Services
For all DME items, refer to Nevada Medicaid DME policy in MSM Chapter 1300. Claims
must include the appropriate physician’s diagnosis code in accordance with policy.
Bundled Services
For any HCPCS code description in which various components are identified, the components may not be billed separately. The Nevada Medicaid rate includes all items in the description.
Durable medical equipment (DME ) medical billing. How to do billing for Medicare and what equipment covered by Medicare. DME Modifiers and CPT codes.
Monday, March 28, 2011
Subscribe to:
Post Comments (Atom)
Popular Posts
-
Modifiers for DME Services Several DME categories and frequently used modifiers are listed below. Inexpensive or Routinely Purchased DME ...
-
KX Modifier-Documentation on File Many policies require the KX modifier be added to the code to indicate specific required documentation i...
-
This clarification in date of service (DOS) applies to the following oxygen concentrators and oxygen transfilling equipment, HealthCare Com...
-
Prosthetics and Orthotics Many of the HCPCS codes in this category require the use of a K modifier. Reference the Lower Limb Prostheses po...
-
Modifiers for DME Services Several DME categories and frequently used modifiers are listed below. Inexpensive or Routinely Purchased DME ...
-
GA, GZ, GY Modifiers-ABN/Not Reasonable and Necessary/Statutorily Excluded The GA modifier is submitted on claims when the supplier has an...
-
Osteogenesis Stimulators E0747, E0748 and E0760 are Class III Devices that must be submitted with a KF modifier. The KF modifier indicates...
-
Incontinent Products Providers must use the appropriate HCPCS code for the size of the recipient. • Codes T4521 – T4528 small, medium, ...
-
Capped Rental Items Items in this category are provided on a rental basis; therefore, RR is one of the modifiers appropriate with these it...
-
Redetermination Request Form Checklist Review the Standard Paper Remittance (SPR) or Medicare Electronic Remittance Advice (ERA) for the c...
No comments:
Post a Comment