Reimbursement & Coding Information

HCPCS Coding Guidance – The link provided below contains Coverage and Payment Rules, codes and general guidelines for seeking DME reimbursement through Medicare. These guidelines do not replace directions provided by CMS. Amerx Health recommends checking with PDAC for the latest updates regarding rules and regulations for dispensing DME products. PDAC – www.dmepdac.com


The Latest in Reimbursement & Coding Information from the Blog

Special Notice: Recent Clarification Announced by CMS

Clarification in Order Requirements for DME Dispensing In a MLN Matters article dated October 12, 2018, CMS announced a clarification in order requirements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). Effective November 13, 2018, “when the prescribing practitioner is also the supplier, and is permitted to furnish specific items of DMEPOS, a separate […]

A- Modifier

Billing For Surgical Dressings: A- Modifiers

One of the most important steps to ensure clean billing of surgical dressings is the appropriate use of the A- modifier.  The A- modifier must be used to indicate two things: Is the dressing billed for a primary or secondary dressing? How many wounds are being treated with the dispensed dressing?  An important differentiation is […]