DME MAC puts nebulizers under review

Friday, November 1, 2013

INDIANAPOLIS – National Government Services, the Jurisdiction B DME MAC, plans to conduct a widespread prepayment review of nebulizers, related drugs, accessories and dispensing fees, it announced Oct. 29. The review is an expansion of a documentation review now being conducted on oxygen equipment and glucose supplies. Suppliers of selected claims will receive a request in the mail asking for copies of the signed and dated detailed written order, applicable dispensing orders, records supporting medical necessity and proof of delivery, according to a bulletin. Suppliers must respond within 45 days or the claim will be denied. If a claim is denied, the supplier may ask for a redetermination within 120 days of the initial denial, the bulletin states.