Codes on hold

Monday, November 23, 2015

WASHINGTON – CMS has decided not to pursue plans to implement new miscellaneous codes for DME and wheelchair components or accessories, but that doesn’t mean they won’t later down the road.
“It’s not that they aren’t going to be making any changes, they just said they aren’t going to make the changes on Jan. 1 as originally communicated,” said Don Clayback, executive director of NCART. “They’re not going to drop it.”
In June, the agency proposed replacing HCPCS codes E1399 and K0108 with six new codes to reflect more accurate payment of Medicare claims. However, payment for some of the proposed codes would have been based on 1986 and 1987 reimbursement levels, say stakeholders.
In October, CMS announced they wouldn’t move forward with the codes, adding that additional information would be provided in the future.
In addition to stakeholder input, Clayback also credits a seemingly relentless wave of industry changes for CMS’s decision.
“Right now there are a lot of changes happening within the Medicare system,” he said. “You’ve got ICD-10 and you’ve got the national rollout of competitive bidding—so maybe this was one change they wanted to re-evaluate before moving forward. That’s our hope.”