CMS bulks up PA program

Agency also adds four codes to ‘Master List’
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Friday, April 19, 2019

WASHINGTON – CMS has added seven codes for complex rehab power mobility devices and five codes for support surfaces to the national prior authorization program, AAHomecare reports.

The agency will roll the PMD codes into the program within 90 days, or July 21 by the association’s estimates.

The support surface codes will added in two phases, within 90 days in California, Indiana, New Jersey and North Carolina, and within 180 days, or Oct. 19, 2019, by AAHomcare’s estimates, in all states.

The codes that will be added to the PA program are K0857, K0858, K0859, K0860, K0862, K0863, K0864, E0193, E0277, E0371, E0372, E0373.

Last year, CMS rolled codes for standard power mobility devices into the program. Before that, there were only two codes in the program: K0856 and K0861.

Additionally, CMS has added four codes for home oxygen therapy to the “master list” of codes potentially subject to prior authorization. Those codes are E1390, E0466, E0784 and L0650.

Once codes are on the list, CMS can then put them on the “Required Prior Authorization List” at anytime via publication in the Federal Register.