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Tag: Coding


CMS releases coding plan for power seat elevation 

November 13, 2023HME News Staff

WASHINGTON – CMS has issued preliminary recommendations for coding and pricing for power seat elevation systems, NCART has reported.  The recommendations include discontinuing the existing HCPCS Level II code E2300, “wheelchair accessory, power seat elevation system, any type,” and establishing two new HCPCS Level II codes at a set fee schedule amount:   EXXXX, “complex rehabilitative power wheelchair accessory, power seat elevation system, any type”  EXXXX,...

Coding, Power seat elevation, Pricing

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AdvancedMD releases codebook 

March 6, 2023HME News Staff

SOUTH JORDAN, Utah – AdvancedMD, a software provider, has released its 2023 CPT/HCPCS Codebook. The resource includes the full list of updated CPT/HCPCS codes, identifying which medical codes have been added, revised and deleted by CMS. “Billing errors are an expensive mistake, equating to approximately $125 billion in uncollected money each year,” said Tim Constantino, vice president and head of product at AdvancedMD. “Not only do incorrect codes result in massive bill collection...

Coding, HCPCS

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van Halem Group adds thought-leader

July 27, 2021HME News Staff

ATLANTA – The van Halem Group has announced that Dr. Doran Edwards has joined its team as a medical advisor. Edwards recently retired after three years with Palmetto GBA, where he was the medical director for the Pricing, Data Analysis and Coding contractor. He was also the medical director of the SADMERC, the predecessor to the PDAC from 2003-08. “Over the last few years, the van Halem Group has been working with manufacturers as they bring new products to market and need to navigate...

Coding, Dr. Doran Edwards, van Halem Group

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CMS schedules coding meeting

March 7, 2019HME News Staff

BALTIMORE, Md. - CMS will hold the annual Healthcare Common Procedure Coding System (HCPCS) Coding and Payment Determinations public meeting for DMEPOS on June 11-12, 2019. The meeting provides an opportunity to discuss coding and payment determinations for all new requests for revisions to the HCPCPS codes. Interested parties can make oral presentations or submit written comments. Registration information will be available at a later date.

Coding, Public meeting

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Contract switches to Palmetto GBA

January 2, 2019HME News Staff

COLUMBIA, S.C. - Palmetto GBA is taking over as the Pricing, Data Analysis and Coding (PDAC) contractor this month. The PDAC receives, evaluates and processes coding verification applications for DMEPOS; establishes, maintains and updates all coding verification decisions on the product classification list; provides coding guidance for manufacturers and suppliers on the proper use of HCPCS; maintains and publishes the NDC/HCPCS crosswalk and OACD pricing files; and conducts DMEPOS data analysis....

Coding, Palmetto GBA, PDAC, Pricing

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Mediware bolsters home health presence

July 13, 2018HME News Staff

LENEXA, Kan. - Mediware Information Systems has acquired Fazzi Associates, a Northampton, Mass.-based provider of coding services to the home health and hospice market. Fazzi also provides consulting, training, benchmarking and research to more than 1,400 agencies across all 50 states and Washington, D.C. “The acquisition creates a unique alignment between two health care (companies)—one in innovative software, the other in outsourced services, consultation, and education,” Mediware...

Coding, Consulting, Fazzi Associates, Home health, Mediware, Mergers & Acquisitions (M&A), Software

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CMS limits K0108 for manual wheelchairs

February 10, 2017Liz Beaulieu, Editor

WASHINGTON - CMS has taken away a Medicare beneficiary's “right to choose,” now that providers aren't allowed to use K0108 for titanium or heavy duty upgrades for manual wheelchairs, industry stakeholders say.In a joint article on Dec. 15, the DME MACs state that the codes for manual wheelchairs—K0001 through K0009—have always included the cost of these upgrades.“Suppliers billing for manual wheelchair bases must not include HCPCS code K0108 in addition to the base wheelchair...

Billing, Coding, Heavy duty, K0108, Manual Wheelchair, titanium

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Mediware managers named to nat'l claims committee

December 21, 2016HME News Staff

LENEXA, Kan. - Two DME software product managers at Mediware Information Systems have been appointed to represent AAHomecare on the National Uniform Claims Committee for 2017. Rebecca Bowden and Kimberly Commito will participate in industry discussions related to maintaining the healthcare provider taxonomy code set, managing 1500 claims forms and monitoring legislative and regulatory changes that impact claims. NUCC comprises a diverse group of healthcare industry stakeholders representing providers,...

Coding, Mediware

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Guest Blog

Billing non-assigned: Myths, part 1

August 5, 2016HME News Staff

Editor's note: In the wake of new market pressures, upgrades, non-assigned claims and cash sales are taking center stage, says industry consultant Andrea Stark. The market has changed and your business should contemplate the suitability of these options, but they are not appropriate in all cases, she says. This is the first in a series of mini-articles that break down the top myths of filing non-assigned claims and leveraging upgrades and cash sales. Myth #1:  If an item is not coded, it does...

Andrea Stark, Coding, Non-assigned

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DME MACs clarify vent requirements

May 6, 2016HME News Staff

WASHINGTON - In highly anticipated clarifications on coding and coverage requirements for ventilators, the DME MACs have acknowledged that coverage for the product category isn't quite black and white.While the National Coverage Determination stipulates that vents are covered for neuromuscular diseases, thoracic restrictive diseases and chronic respiratory failure, the DME MACs acknowledge that these disease groups overlap conditions described in the local coverage determination for respiratory assist...

Bi-Level PAP, Coding, Coverage, CPAP, Vents

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