billing the dmercs and others for infusion pumps - ION Solutions

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HCPCS HCPCS Modifiers EY – No physician or other health care providerorder for this item or service GA – Waiver of liability statement issued asrequired by payer policy, individual case GY - Item or service statutorily excluded ordoes not meet the definition of any Medicarebenefit GZ – Item or service expected to be denied asnot reasonable and necessary JB - Administered subcutaneously KX - Requirements specified in the medicalpolicy have been met
HCPCS CODES E0781: AMBULATORY INFUSION PUMP,SINGLE OR MULTIPLE CHANNELS,ELECTRIC OR BATTERY OPERATED, WITHADMINISTRATIVE EQUIPMENT, WORN BYPATIENT A4221: SUPPLIES FOR MAINTENANCE OFDRUG INFUSION CATHETER, PER WEEK(LIST DRUG SEPARATELY) A4222: INFUSION SUPPLIES FOR EXTERNALDRUG INFUSION PUMP, PER CASSETTE ORBAG (LIST DRUGS SEPARATELY)
Page 1: BILLING THE DMERCS ANDOTHERS FOR IN
Page 4 and 5: BUZZWORDSDIF-DME Information FormDM
Page 6 and 7: WHAT IS REIMBURSABLE DME? Payment m
Page 8 and 9: HOW IS DME CLASSIFIED? IN=Inexpensi
Page 10 and 11: PORTABLE PUMP: RENTAL PROVISIONS Ca
Page 12 and 13: OLD PUMP CMN—CMS FORM 851
Page 15 and 16: SNF CONSOLIDATED BILLING The Social
Page 17 and 18: MAIN DME CONTRACTORS Durable Medica
Page 19 and 20: DME MAC Types of Claims DME Prosthe
Page 21 and 22: NSC Contact Infohttp://www.palmetto
Page 23 and 24: CEDI Single front-end electronic so
Page 25 and 26: DME MAC COVERED DRUGS Epoetin alfa
Page 27 and 28: OTHER MODIFIERS JB: Administered su
Page 32 and 33: DIF DOCUMENTATIONSection 1833(e) of
Page 34 and 35: COVERAGE CONDITIONS FOR EXTERNALPUM
Page 44 and 45: DMERC FEE SCHEDULECode Description
Page 46 and 47: 96416—INITIATION OF PROLONGEDINFU
Page 48 and 49: 96521-REFILLING AND MAINTENANCE OF
Page 50 and 51: A WORD ABOUT PRIVATE PAYERS(May Be
Page 52 and 53: OTHER THINGS ABOUT PRIVATE PAYERS W
Page 54 and 55: COMPLIANCE ISSUES Billing for items
Page 56 and 57: RESPONDING TO REQUESTS (CIGNA)Below
Page 58 and 59: CONCLUSIONS DME billing is complex,
Page 60: DME RESOURCES Durable Medical Equip

billing the dmercs and others for infusion pumps - ION Solutions

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