billing the dmercs and others for infusion pumps - ION Solutions

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HOW IS DME CLASSIFIED? IN=Inexpensive/routinely purchased...DME; FS=Frequency Service...DME; CR=Capped Rental... DME; OX=Oxygen and Oxygen Equipment... OXY; OS=Ostomy, Tracheostomy and Urologicals..DME IN=Inexpensive/routinely purchased...DME; S/D= Surgical Dressings...S/D; Prosthetics and Orthotics...P/O; Supplies...DME; and TENS...DME,
PORTABLE PUMP RENTAL: CR 30.6 Capped Rental Items For these items of DME, contractors pay the feeschedule amounts on a monthly rental basis not toexceed a period of continuous use of 15 months. Inthe tenth month of rental, the beneficiary is given apurchase option (see §30.5.2). If the purchase optionis exercised, contractors continue to pay rental feesnot to exceed a period of continuous use of 13 monthsand ownership of the equipment passes to thebeneficiary. If the purchase option is not exercised,contractors continue to pay rental fees until the 15month cap is reached and ownership of theequipment remains with the supplier (see §30.5.4). Inthe case of electric wheelchairs only, the beneficiarymust be given a purchase option at the time theequipment is first provided (see §30.5.3).
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 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 42 and 43: HCPCS HCPCS Modifiers EY - No physi
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
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