Tag: Documentation

WASHINGTON – Reps. Terri Sewell, D-Ala., and Adrian Smith, R-Neb., are collecting signatures for a sign-on letter asking CMS to accept the standard written order as the only necessary documentation to establish medical necessity for audits of home oxygen, sleep and non-invasive ventilation claims submitted during the public health emergency, according to AAHomecare.  The letter asks CMS to protect patient access by instructing contractors to use CMS’s widely accepted oxygen...

WASHINGTON – Reps. Terri Sewell, D-Ala., and Adrian Smith, R-Neb., are collecting signatures for a sign-on letter asking CMS to accept the standard written order as the only necessary documentation to establish medical necessity for audits of home oxygen, sleep and non-invasive ventilation claims submitted during the public health emergency, according to AAHomecare.  The letter asks CMS to protect patient access by instructing contractors to use CMS’s widely accepted...

WASHINGTON – CMS has added 10 more HCPCS codes to a required list for a face-to-face encounter /written order prior to delivery, according to VGM Government Relations.  The new codes include the following for back, knee and ankle/foot braces: L0631, L1843, L1932, L1940, L1951, L1960, L1970, L2005, L2036. Also included: E0748, osteogenesis stimulator, electrical, non-invasive, spinal applications.  The effective date for the news codes is April 2023.  The required...

WASHINGTON – Twenty two members of the House of Representatives have asked CMS to streamline documentation for home oxygen therapy, AAHomecare reports. A sign-on letter spearheaded by Reps. Terri Sewell, D-Ala., and Larry Bucshon, R-Ind., requests that CMS: “Use the opportunity of expanding the current National Coverage Determination for oxygen to establish a clear set of criteria to support medical necessity and instruct the contractors to rely solely on the Standard Written Order...

WASHINGTON – CMS on Feb. 10 published a change request notifying the DME Medicare Administrative Contractors of the agency’s new national coverage determination for home oxygen therapy.  CMS notes the following changes are effective for claims with dates of service starting Sept. 27, 2021:  expansion of oxygen coverage for acute and chronic conditions;  expansion of coverage for short and long-term need (when hypoxemia exhibited);  the ability of the MACs...

WASHINGTON – AAHomecare, VGM & Associates, the Council for Quality Respiratory Care and 11 other organizations are asking CMS to eliminate the medical record review for home oxygen therapy and to accept the clinician prescription/standard written order as the required documentation for establishing medical necessity.  These changes would protect against fraud and abuse, reduce the burden on clinicians and suppliers, and protect access for Medicare beneficiaries, the groups say in an...

WASHINGTON - The DME MACs on May 7 announced that they will not require CMNs for oxygen claims during the COVID-19 public health emergency. The update follows CMS's decision not to enforce clinical indications of coverage for the oxygen NCDs and LCDs, as outlined in an April 6 interim final rule. “After carefully reviewing the CMN and the related claims processing issues that would result from having missing information or having clinical information for which the form was intended,...

ATLANTA - The van Halem Group will provide clinical prescreen reviews and appeal services for custom orthotics and prosthetics provided by Ossur's customers.The services will include, but will not be limited to, a prescreen review of documents to determine if all coverage requirements have been met prior to submission for reimbursement, as well as access to the van Halem Group's team of clinical experts.“We know all too well the challenges and hurdles our customers face when submitting claims...

OVERLAND PARK, Kan. — A new framework for interoperability from WellSky allows its provider customers to better communicate across various patient data exchanges — all electronically. Here's what Amy Shellhart, senior vice president of product management, had to say about how WellSky I/O is helping to break down “electronic silos” of documentation, significantly advancing efforts to achieve what the company calls “true interoperability.”HME News: As we know, there...

WASHINGTON - AAHomecare recommends that providers continue to obtain written orders prior to delivery for HME until CMS publishes a “required list.” Earlier this month, the DME MACs said a new standard written order would be the only type of order needed for HME claims starting with dates of service Jan. 1, 2020. But it also said certain HME on a “required list” would still be subject to face-to-face and WOPD requirements. While AAHomecare has confirmed that as of Jan....