In order to receive timely payments, it
has become imperative for DME suppliers to demonstrate
medical necessity of the durable medical equipment. Without securing and
retaining the right documentation of medical necessity, obtaining Medicare
payments can become a nightmare for those involved in furnishing DME and
submitting claims.
All this has pushed the need to have
expert billers and coders who are aware of the Medicare regulations and ICD-10 coding changes.
DME Code Changes
Here are some of the April changes to
the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
items and services.
Centers for Medicare and Medicaid
Services (CMS) has not only added a diabetes code but also changed oxygen
coding for the DME fee schedule by altering the HCPSC Level II modifiers.
Diabetic DME codes- there have been
some changes that will affect coding of HCPCS Level II code K0903. According to
the CMS, the fees for K0903 are set on the basis of fees for code A5513.
CMS released the DMEPOS fee schedule
for 2019 that will be effective for Medicare claims that have a service date on
or after 1st of January. Also, according to the AOPA (American Orthotic and
Prosthetic Association), in 2019, the Medicare Fee Schedule for O&P services
will also increase by 2.3% compared to the rates in 2018.
Surge in demand for trained coders
Coders need to pay close attention to
the details of doctor’s procedures and diagnoses. They will have to use very
specific ICD-10 and CPT codes to get
reimbursed. For instance, if they are using billing diagnosis code F11.20 on a
claim with procedure code 80307, it will reimburse them about $30 less than
specifying the exact opioid being used by the patient.
To get paid on time, many suppliers
have started outsourcing their billing needs to a third party. Outsourcing is
giving them the opportunity to get reimbursed on time, without having to go
through the hassles of keeping up with coding and regulatory changes.
About 247 Medical Billing Services:
We are a medical billing company that offers ‘24/7 Medical
Billing Services’ and
support physicians, hospitals, medical institutions and group practices with
our end to end medical billing solutions. We help you earn more revenue with
our quick and affordable services. Our customized Revenue Cycle Management
(RCM) solutions allow physicians to attract additional revenue and reduce
administrative burden or losses.
Contact:
247 Medical Billing
Services
Tel: +1
888-502-0537
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