As a medical consultant and practice manager, I am often asked, “What are your top management pearls?” Without further ado, here are my top 5: Always collect insurance information over the phone from a patient. Always call and check benefits for standard procedures or DME that will be dispensed. Know a patient’s deductible/ co-insurance and […]
When dispensing surgical dressings, it is important to differentiate between primary and secondary dressings and to use them in conjunction when indicated. PRIMARY DRESSINGS Primary dressings are therapeutic or protective and can be applied directly to ulcers. SECONDARY DRESSINGS Secondary dressings are needed to secure and/or aid in the function of a primary dressing. A […]
The Centers for Medicare and Medicaid Services (CMS) require that DME suppliers maintain proof that any item dispensed was received by the beneficiary in the form of a Proof of Delivery document. This document must be maintained for at least seven years. This could be requested by DMEMACs, recovery auditors, supplemental medical review contractors, or […]
The Centers for Medicare and Medicaid Services (CMS) requires that DME suppliers maintain proof that any item dispensed was received by the beneficiary in the form of a Proof of Delivery document. This could be requested by DMEMACs, recovery auditors, supplemental medical review contractors, or Comprehensive Error Rate Testing (CERT) medical review contractors. In our […]
The Centers for Medicare and Medicaid Services (CMS) requires that DME suppliers maintain proof that any item dispensed was received by the beneficiary in the form of a Proof of Delivery document. It may be requested by DMEMACs, recovery auditors, supplemental medical review contractors, or Comprehensive Error Rate Testing (CERT) medical review contractors. In last […]
The Centers for Medicare and Medicaid Services (CMS) requires that DME suppliers maintain proof that any item dispensed was received by the beneficiary in the form of a Proof of Delivery document. This proof may be needed to substantiate payment. It may be requested by DMEMACs, recovery auditors, supplemental medical review contractors, or Comprehensive Error […]
Compression is an essential component of both healing and preventing venous leg ulcers. Not only do compression garments, such as the EXTREMIT-EASE® Compression Garment, help to treat difficult lower leg ulcers, they can also be stocked in your office and dispensed to patients as a DME item, providing your patients with excellent care and providing […]
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 […]
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 […]
Some surgical dressings only have coverage for full thickness ulcers. These include alginates, foams, and hydrogels. When dispensing a dressing that is only covered for full thickness ulcers, it is important to not only document the presence of a full thickness ulcer, but also submit a diagnosis code that reflects the presence of a full […]