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Content Section
- Delay of the National DMEPOS Competitive Bidding Program: Claims Processing -- Section 154 of the Medicare Improvements for Patients and Providers Act of 2008 delays the DMEPOS Competitive Bidding Program. Therefore, in the 10 areas where competitive bidding was initiated, Medicare will pay for DMEPOS items, retroactive to June 30, 2008, using the standard DMEPOS fee schedule amounts. CMS will begin processing all incoming claims under standard FFS rules, no later than July 28, 2008. Any claims that were held will be processed no later than August 4, 2008. To the extent possible, CMS will also automatically reprocess claims that were paid under the Competitive Bidding Program and those claims denied based solely due to DMEPOS Competitive Bidding Program rules. Note that in some instances suppliers will need to alert the contractor to claims that should be adjusted. CMS will soon issue contractor instructions and issue accompanying MLN Matters articles with more information. (posted 7/18/08)
- The Medicare Improvements for Patients and Providers Act of 2008 was enacted on July 15, 2008. This new law has delayed the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. Items that had been included in the first round of the DMEPOS Competitive Bidding Program can be furnished by any enrolled DMEPOS supplier in accordance with existing Medicare rules. Payment for these items will be made under the fee schedule. Additional guidance regarding this new law will be forthcoming. (posted 7/16/08)
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- Consolidated Billing for Skilled Nursing Facility (SNF) Residents Claims Billed to Medicare Carriers or DMERCs by Physicians, Non-Physician Practitioners, and Suppliers
- Consolidated Billing for Skilled Nursing Facility
- Electronic Data Interchange (EDI)
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- National Supplier Clearinghouse- contains information about supplier enrollment
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- Information for Providers
- Medicare Modernization Update
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- Medicare Program; Payment for Respiratory Assist Devices With Bi-Level Capability and a Backup Rate (CMS-1167-F) and Press Release (published in the Federal Register on January 27, 2006)
- Medicare Secondary Payer and You
- Medicare Secondary Payer Manual
- Coordination of Benefits
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| - Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding
- CMS Online Manual
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- Program Memoranda
- Medicare Policy Benefit Manual (Chapter 15, Section 110)
- Medicare Claims Processing Manual (Chapter 20 - Durable Medical Equipment, Prosthetics, Orthotics and Supplies)
- To receive changes to the CMS Quarterly Provider Update, subscribe to the CMS-QPU listserv from the CMS Mailing Lists Page.
- Medicare National Coverage Determinations Manual
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- Healthcare Common Procedure Coding System (HCPCS)
- 2006 Jurisdiction List -- A spreadsheet containing an updated list of the HCPCS for Durable Medical Equipment Regional Carrier (DMERC) and Part B local carrier jurisdictions is updated annually to reflect codes that have been added or discontinued (deleted) each year. Changes in section 20.3, Publication 100-04 of the Claims Processing Manual are reflected in the recurring update notification.
- Procedures For Coding and Payment Determinations For Clinical Laboratory Tests and For Durable Medical Equipment
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- Chapter 5- Program Integrity Manual - Items and Services Having Special DMERC Review Considerations
- Chapter 12- Program Integrity Manual - FI, Carrier, DMERC and RHHI Interaction and Coordination with Program Safeguard Contractors (PSCs)
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