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Also Noted

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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Have ABNs become 'gray area'?

April 5, 2013Elizabeth Deprey

WASHINGTON - The proper use of advance beneficiary notices (ABNs) has shifted—and not in the HME provider's favor, industry stakeholders say. CMS has evolved its policy to the point where providers can no longer use ABNs to “upgrade” within the same code, says Andrea Stark, a reimbursement consultant with MiraVista. “We are operating in gray areas,” she said. “It has definitely been an erosion of how we utilize this.” Case in point: In January,...

Advance Beneficiary Notice (ABN), CMS, Medicare, MiraVista, PDAC

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Also Noted

CMS extends review of K0009

March 1, 2013HME News Staff

WASHINGTON - CMS has requested an additional 30 days to complete its coding verification review of K0009, a code representing miscellaneous custom ultralight wheelchairs, according to a bulletin from Noridian Administrative Services. The review is designed to resolve issues involved with classifying these items under the HCPCS. The new effective end date for all products currently coded K0009 is April 30, 2013, and manufacturers that submitted a coding verification application to the PDAC prior to...


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