SADMERC Swamped with Coding Reviews

COLUMBIA, S.C.–Because HIPAA mandates that all insurance
carriers now use HCPCS codes for billing DME, the SADMERC has been
inundated with an unprecedented number of requests from
manufacturers for coding verifications, the Medicare contractor
reported last week.

For this reason, the SADMERC said it would be unable to respond
to certain requests within its typical response time of 90
days.

During a CMS Open Door Forum last week, manufacturer
representatives expressed concern, especially considering that the
contractor will have to match existing power chair and scooter
models with 49 newly introduced mobility billing codes before they
become effective next year.

“Wheelchairs are a priority [for the SADMERC],” an official said
at the forum, held Thursday in Washington, D.C. “We’re anticipating
these delays will not last long, probably for a few months, when
the wheelchair coding events start happening,” she said, adding
that by the end of the year “the SADMERC will be back on
track.”

More information is posted on the SADMERC Web site, available by

clicking here.