Briefs: On the way: Correction for custom prosthetic claims

Thursday, August 25, 2011

BALTIMORE - Medicare will pay for certain custom prosthetic items under Part B when they are provided to a beneficiary during a non-covered Part A stay in a hospital or skilled nursing facility. These claims have been incorrectly denied since April 4. In a July 27 message, however, CMS stated it was issuing instructions to correct the problem, but that the correction would not be implemented until Jan 1, 2012. Until then, the DME MACs will reprocess any claims that were incorrectly denied when such claims are brought to their attention.

New execs named at National Sleep Therapy

SCARBOROUGH, Maine - CPAP provider National Sleep Therapy in July hired Dr. Stephen Fitzmeyer as its new chief medical informatics officer. Fitzmeyer has more than 25 years of computer programming and medical informatics experience. The provider also named Patricia McKenzie as its vice president of operations. She has more than 15 years of experience in strategic operations.

Smith & Nephew tweets

ST. PETERSBURG, Fla. - Smith & Nephew in July ramped up its Twitter efforts. The maker of negative pressure wound therapy pumps and other products uses the handle @woundcare. "More and more we are trying to make our presence available in different channels of communication reaching users, not just clinicians, but sometimes even patients," says Judy Reed, director of marketing communication for wounds for North America.

Study: Compression stockings could reduce OSA

NEW YORK - Could something as simple as compression stockings alleviate obstructive sleep apnea in some patients? French researchers think so. In a study to be published online in the American Journal of Respiratory and Critical Care Medicine, researchers found that patients suffering chronic venous insufficiency who wore compression stockings had a reduction in daytime fluid accumulation in the legs. That reduced the amount of fluid flowing into the neck at night, reducing the number of apneas and hypopnea by more than a third, said lead researcher Dr. Stefania Redolfi of the University of Brescia in Italy. In the study, 12 patients were randomly assigned to wear compression stockings for one week, or to a one-week control period of not wearing stockings. At the end of the first week, they switched to the other arm of the study. At the end of the compression stocking period, subjects saw an average 62% reduction in overnight leg fluid volume; a 60% reduction in neck circumference increase; and a 36% reduction in apneas and hypopnea per hour of sleep.

Therapeutic shoes have whopping denial rate

WASHINGTON - National Government Services, the Jurisdiction B DME MAC, is continuing its prepayment review for therapeutic shoes. Of 246 claims reviewed by June 30, 2011, 229 (93%) were denied. The top two reasons were no documentation received (53%) and denied as non-covered (31%). The top reasons contributing to those denials are not responding to the request for documentation letter within 30 days; and insufficient or no medical records from the physician.