Tag: PDAC
CMS, PDAC detail plans for new E1028 code
January 20, 2025HME News Staff
WASHINGTON – CMS has accepted some but not all NCART’s recommendations as part of its preliminary decision on the PDAC’s code application to review E1028 and establish three new codes to describe manual, swing-away and retractable or removable mounting hardware used in conjunction with medically necessary wheelchair accessories. NCART agreed with the programmatic need for the change but requested CMS consider several edits to more accurately describe the components associated with...
In brief: Cath codes, sleep predictions, wildfire support, pulse ox guidance
January 10, 2025HME News Staff
WASHINGTON – The Pricing, Data Analysis and Coding (PDAC) contractor for CMS seeks primary contact information from manufacturers and distributors as it prepares to roll out new HCPCS codes for hydrophilic intermittent urinary catheters on Jan. 1, 2026, AAHomecare reports.
Manufacturers and distributors can provide their primary contact by completing this form by March 31. Over the course of the year, the PDAC will work with the primary contact to determine if their products qualify...
PDAC preps for new cath codes
January 9, 2025HME News Staff
WASHINGTON – The Pricing, Data Analysis and Coding (PDAC) contractor for CMS seeks primary contact information from manufacturers and distributors as it prepares to roll out new HCPCS codes for hydrophilic intermittent urinary catheters on Jan. 1, 2026, AAHomecare reports.
Manufacturers and distributors can provide their primary contact by completing this form by March 31. Over the course of the year, the PDAC will work with the primary contact to determine if their products qualify...
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....
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,...
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...