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Tag: Prostheses


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CGS launches review of No. 1 product category for CERT errors

March 22, 2021HME News Staff

NASHVILLE, Tenn. – CGS will be conducting complex post-pay, service-specific medical review of lower limb prostheses, L5700 and L5701, the contractor announced on March 19. “This review will be conducted because data analysis revealed that Jurisdiction C’s allowed dollars for L5700 and L5701 were significantly above expected amounts,” CGS stated. “Additionally, the orthotics policy group ranked No. 1 in total comprehensive error rate testing (CERT) errors.”...

Audits, CGS, Medical review, Prostheses


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Specialty Providers

CMS holds off on coverage changes for prostheses

November 3, 2015HME News Staff

WASHINGTON - CMS has taken a step back from its controversial plans to change the coverage requirements for lower limb prostheses.The agency's DME MACs released a draft local coverage determination in July, setting off a chain of events that included a public hearing, a protest, high-stakes meetings and a “We the People” petition.“Both CMS and its contractors have heard your concerns about access to prostheses for Medicare beneficiaries,” the agency stated in an announcement...

Coverage Requirements, LCD, Prostheses


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