Downsize Those DSOs

HCPCS Code E0910
(Trapeze)

Average Medicare DSO
53 days

A trapeze (E0910), an accessory to the hospital bed rental to assist patients with getting in and out of the bed, has a higher than average DSO due to its coverage requirements. A trapeze is covered if the patient requires it to sit up due to a respiratory condition (this should be reflected in the diagnosis codes given by the referral source). A trapeze also is covered if the patient requires it to change body position for other medical reasons (this should be listed on the hospital bed CMN with question No. 7 being a “yes”) or to get in or out of bed (the reason the patient needs assistance can be detailed in the HAO record, the comment section of the hospital bed CMN). If the criteria are not met through answers on the hospital bed CMN and HAO record, the trapeze will be denied. Coverage criteria must be documented in the patient’s medical record and may be called upon if the claim is developed or denied and an appeal is to be made. During intake, customer service representatives should ask questions that reflect what is needed to prove medical necessity to properly qualify the patient. If the patient meets the criteria, then the CSR can assume that Medicare will pay for the trapeze as an accessory to the hospital bed. Ask the qualifying questions upfront. It is better to know prior to delivery rather than on the back end of a denial.

Data represents a categorized and weighted analysis of approximately 1.1 million Medicare paid claim lines adjudicated by the four DMERCs between Nov. 1, 2005, and Nov. 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

Sarah Hanna is a reimbursement consultant and vice president of ECS Billing & Consulting, Tiffin, Ohio. She can be contacted at 419/448-5332 or [email protected].