Surgical Dressings with HCPCS A6209-A6214
Surgical dressings are the subject of a new widespread prepay review by National Government Services, the Jurisdiction B DME MAC.
Author
Sarah Hanna
Sarah Hanna is a reimbursement consultant and vice president of ECS Billing & Consulting, Tiffin, Ohio, and specializes in proper billing protocols, Medicare coverage guidelines and billing office procedures. She can be contacted at 419/448-5332 or [email protected].
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Make Sure Enteral Claims Are Complete
The HCPC B4150 is one of the most common enteral nutrients billed to Medicare. But a review of these claims found errors in -
Medicare Reimbursement
PR16 Claim service lacks information needed for adjudication
National Government Services, the Jurisdiction B DME MAC, recently addressed issues with claims filing resulting in a PR16 denial code with an M124 remark code. -
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Be Careful with Supply Refills
Providers have responsibilities in contacting the patient and providing their needed supplies on a regular basis when providing refills. -
Watch Out for the KE Modifier
On Jan. 1, 2009, the KE modifier hit the HME stage. Since then, this little modifier has been causing some providers a lot of anxiety and stress. -
C050 These are non-covered services because this is not deemed a medical necessity by the payer
With elimination of the CMN came the KX modifier. With the KX modifier came the requirement for providers to prove medical necessity from documentation in the patient's medical record. -
Working Down Denials
The denial reason code CO150 (Payment adjusted because the payer deems the information submitted does not support this level of service) is No. 5 on the list of RemitDATA's Top 10 denial codes for Medicare claims. -
E2402 Negative Pressure Wound Therapy electrical pump, stationary or portable
National Government Services, the Jurisdiction B DME Medicare Administrative Contractor, has recently completed a widespread prepay review of negative -
M3 Same or similar equipment
The Jurisdiction D DME MAC (Noridian Administrative Services) says it is seeing many claims for wheelchairs and power mobility devices were it has been