Coding revisions coming

Sunday, October 31, 2004

WASHINGTON - After four years of lobbying for the modernization of the HCPCS coding process, DME manufacturers are eagerly awaiting word from CMS on proposed revisions. CMS officials say they may annoucnes changes by the end of the year.

At a meeting in early August, a coalition of manufacturers led by Marcia Nusgart called on CMS to establish and publish the criteria used in the coding process; modernize coding application; allow open meetings between applicant, HCPCS work-group and national panel; include DMEPOS experts in decision making; give more specific reasons for code denial; and establish an appeals process.

Nusgart said the coalition’s suggestions were well received, but she called on CMS to take action.

“They understand this is a tremendous problem and they are committed to fix it, but implementation is another issue,” Nusgart said. “The system must be timely, transparent and understandable by manufacturers and their customers.”