Regulatory Updates

State: All

Billing correctly: Power Mobility Devices

Date Posted : 12/15/2022

Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies

The Power Mobility Devices booklet explains how to properly document and bill for power mobility devices (PMDs). Follow these steps to bill for PMDs:

• Obtain the Standard Written Order (SWO)
• Make a prior authorization request
• Complete a home assessment
• Keep the following documents: SWO, face-to-face visit supporting documents, written home assessment report, and proof of delivery
• Review all information to avoid improper payments

An Office of Inspector General report stated that Medicare improperly paid claims for PMD repairs. To properly bill for PMD repairs:

• Show repairs are reasonable, necessary, or meet the requirements
• Document labor time adequately
• Show that DMEPOS suppliers must provide repair warrantees
• Specify that wheelchair repair costs can’t exceed a certain amount over a device’s 5-year lifetime

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State: All

New Waived Tests for Home Health and Hospice

Date Posted : 08/4/2022

Date Effective : 10/1/2022

Program: Home Health, Hospice

Listed below are the latest tests approved by the Food and Drug Administration (FDA) as waived tests under CLIA (Clinical Laboratory Improvement Amendments of 1988). The CPT code, effective date and description for the latest tests approved by the FDA as waived tests under CLIA are as follows:

• 82010QW, 82962, May 27, 2022, AmVentureX Inc. BioCoach Blood Glucose and Ketone Monitoring System;
• 80305QW, June 07, 2022, Micro Distributing STATDIP One Step Drug Test;
• 80305QW, June 07, 2022, Micro Distributing STATCup II One Step Drug Test Cup;
• 87880QW, June 09, 2022, Clarity Diagnostics LLC Clarity Strep A Rapid Test Strip;

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State: All

Home Health & Hospice: Medicare Provider Resources

Date Posted : 11/17/2022

Program: Home Health, Hospice

November is Home Care & Hospice Month, is a great time to get familiar with these resources:

• Medicare Payment System educational tool.
• Hospital-based Hospice Medicare provider compliance tips.
• Creating an Effective Hospice Plan of Care fact sheet.
• Enhancing RN Supervision of Hospice Aides Services fact sheet.
• Safeguards for Medicare Patients in Hospice Care fact sheet.

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State: All

Home Health Agencies – Free Medicare Home Health You Tube Videos

Date Posted : 11/3/2022

Program: Home Health

National Government Services (NGS) has a plethora of educational Medicare Home Health YouTube videos regarding billing and documentation. These videos are free, short in length and very informative. They contain information on home health eligibility criteria, homebound status, the advance beneficiary notice (ABN) and more. Please share these links with your clinical and billing staff as appropriate:

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State: All

Hospice – Free Medicare Hospice YouTube Video

Date Posted : 11/3/2022

Program: Hospice

National Government Services (NGS) has an array of educational Medicare Hospice YouTube videos regarding billing and documentation. These videos are free, short in length and very informative. They contain information on the required elements of the hospice notice of election statement (NOE) and how to correct a date on the hospice NOE. Please share these links with your clinical and billing staff as appropriate:

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State: All

DMEPOS enrollment transition

Date Effective : 11/7/2022

Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies, Pharmacy

National Supplier Clearing House is transitioning to:

1. National Provider Enrollment West - Western Region awarded to Palmetto GBA
2. National Provider Enrollment East - Eastern Region awarded to Novitas Solutions

Important Information Regarding Upcoming Changes to the DMEPOS Enrollment Contractor: Nov. 6, 2022, is the last day that the National Supplier Clearinghouse (NSC) will process Medicare enrollment applications for DMEPOS suppliers. Effective Nov. 7, 2022, two new contractors will process all DMEPOS enrollment applications:

• Novitas Solutions: Alabama, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin, District of Columbia, Puerto Rico, US Virgin Islands
• Palmetto GBA: Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, American Samoa, Guam, Northern Mariana Islands

CMS-855S application The Provider Enrollment, Chain, and Ownership System (PECOS) is the best option to complete and submit your enrollment applications. PECOS supports the Medicare supplier enrollment process by allowing registered users to securely submit and manage Medicare enrollment information online. If you utilize paper applications, continue to use the current CMS-855S form found on our website; however, disregard the address listed on page 4 of the application advising to send the application to the National Supplier Clearinghouse (NSC). We will notify you via our eNews email when the new form is available, how to access it, and the updated address to submit your CMS-855S applications. What happens to my application upon transition? If you are within the eastern state region for DMEPOS, your existing enrollment record will be transferred to Novitas in PECOS. If you are within western state region for DMEPOS, your existing enrollment record will be transferred to Palmetto GBA in PECOS. On November 7, any application still in progress or under review will be transferred from the NSC to Novitas Solutions and Palmetto GBA and receive a new document control number (DCN). A Novitas/Palmetto representative will communicate your new DCN by calling or emailing the contact person listed on the application. There is no action required from you!

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