Tag: support surfaces

WASHINGTON - A prior authorization requirement for Group 2 pressure reducing support surfaces will expand to all states and territories effective Oct. 1. Prior auths for dates of delivery on or after July 22 were already in effect in California, Indiana, New Jersey, and North Carolina for E0193, E0277, E0371, E0372 and E0373. CMS announced the addition of the codes to the national prior authorization program in April, along with seven additional codes for complex rehab power mobility devices. During...

WASHINGTON - CMS has implemented a shorter, five-day turnaround time for prior authorizations for support surfaces, but there are no changes to the coverage criteria, CMS officials said during a Special Open Door Forum on June 4.The agency will turn around expedited PA requests for support surfaces in two days, it says.“We realize that the support surfaces process is a lot different than with power mobility,” a CMS official said during the call. CMS announced in April that it planned...

WASHINGTON - CMS will turn around requests for prior authorizations for support surfaces in five business days, the agency announced during a Special Open Door Forum on Tuesday.CMS will turn around expedited requests in two days, it says.Starting July 22, providers in four states—California, Indiana, New Jersey and North Carolina—will have to submit prior authorization requests for five codes for support surfaces. Starting Oct. 21, providers in all states will have to submit prior authorization...

With CMS launching a new mandatory prior authorization program for group 2 support surfaces in July, suppliers are understandably concerned about accommodating patients with immediate needs for pressure support, particularly upon hospital discharge.Discharge planners typically start care coordination when the doctor signs the order to go home. Suppliers point out that the authorization process takes time. Suppliers must gather supporting documentation from multiple sources, and contractors will scrutinize...

WASHINGTON - CMS has added seven codes for complex rehab power mobility devices and five codes for support surfaces to the national prior authorization program, AAHomecare reports.The agency will roll the PMD codes into the program within 90 days, or July 21 by the association's estimates.The support surface codes will added in two phases, within 90 days in California, Indiana, New Jersey and North Carolina, and within 180 days, or Oct. 19, 2019, by AAHomcare's estimates, in all states.The codes...

CLEVELAND - Compass Health Brands has acquired Meridian Medical, a manufacturer of gel overlays, cushions, support surfaces, lymphedema systems and respiratory products. “This acquisition expands our best in class product portfolio and provides us a solid platform in the pressure prevention category,” said Stuart Straus, president and CEO of Compass Health Brands. The Knoxville, Tenn.-based Meridian markets its products under the brands Air Lift, CareFore, Ultra Care, Gel Lite, Core Comfort...

YARMOUTH, Maine - Group 2 pressure reducing support surfaces had a claims error rate of 73.7% from April 1, 2014, to June 30, 2014, the Jurisdiction B DME MAC has reported. Top denial reasons included insufficient documentation of larger or multiple stage III or stage IV pressure ulcers on trunk or pelvis that have not improved over the last month, and insufficient documentation due to a missing signature. CPAP devices had a claims error rate of 67% for the same timeframe, the MAC reported. Top denial...

INDIANAPOLIS - The claim error rate for Group 2 pressure reducing support surfaces (E0277) was 74% between July 1, 2013, and Sept. 31, 2013, according to a prepay review by National Government Services (NGS), the DME MAC for Jurisdiction B. NGS reviewed 275 claims: 239 were denied and 36 were approved. It found that 21% of claims were denied due to no response to the additional documentation request letter…The claim error rate for glucose test strips (A4253) was 98.5% between Oct. 1, 2013, and Dec....

SAN ANTONIO - Getinge AB, a player in the European support surfaces market, is positioning itself to become a major player on this side of the Atlantic with its acquisition of Kinetic Concept, Inc.'s (KCI) support surfaces business.The Sweden-based Getinge in August agreed to buy Therapeutic Support Systems (TSS) from KCI for $275 million.“TSS is very strong in North America, with 60% of its revenues coming from the U.S. market,” Johan Malmquist, CEO of Getinge Group, said during a conference...

SAN ANTONIO - Kinetic Concepts, Inc. (KCI) announced Aug. 15 that it has made good on its plan to offload its hospital bed business, selling it for $275 million to Swedish company Getinge AB.As part of the deal, Getinge, a player in the ulcer prevention market in Europe, will offer jobs to employees of KCI's Therapeutic Support Systems (TSS) business, according to a press release. TSS provides hospital beds, mattress replacement systems and other support surfaces, and generated revenues of $247 million...