Good news for providers

Monday, March 31, 2008

In early 2007, E0217 was the subject of audits in Regions A, B and C. In many cases, PSCs found little to no provider documentation supporting the use of E0217.
In 2005 and 2006, several providers billed Medicare for hundreds of heat pumps every month. Yet it was the lack of equipment guidelines and patient qualification rules that made the code ripe for abuse.
As a result, the SADMERC and the PSCs are expected to introduce new guidelines for both equipment and prescriptions in 2008.
This is good news for providers who saw their claims needlessly delayed because of up-coding and abuse by others.
My prediction for 2008 is that demand for legitimate E0217 products will continue because of the increasing need for hospital-quality drug-free pain relief, and that the orthopedic coolers and alternating heat/cold therapy systems that sparked the audits will be disqualified.

Scott Gammons, vice president
Adroit Medical Systems, Inc.