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Further, if a DME supplier selects the KX modifier, the Medicare contractor automatically processes the claim. [read post]
28 Apr 2016, 1:40 pm
"By contrast, here's Judge Paez's take:"In my view, DME suppliers do not exercise substantial professional or managerial discretion within Medicare’s reimbursement scheme because Medicare’s rules and regulations confine them to a ministerial role and leave all critical determinations of medical need to the beneficiary’s physician. [read post]
  CMS proposes to exclude some categories of drugs, however, such as:  contractor-priced drugs; influenza, pneumococcal pneumonia and hepatitis B vaccines; drugs infused with a covered item of DME (excluded during phase 1 only “so that DME policy can focus on issues related to DME and so that the model does not interfere with decisions related to the inclusion or exclusion of these drugs in DME competitive bidding”); separately billable… [read post]
9 Mar 2016, 10:17 am by Michael D. Fitzgerald
Wheelchairs, like other Durable Medical Equipment (“DME”), are reimbursed by federal and state programs based upon certain criteria. [read post]
2 Mar 2016, 5:51 am by Gallivan & Gallivan
 In many plaintiffs personal injury offices, these examinations are referred to as Defense Medical Examinations or “DME’s”. [read post]
1 Mar 2016, 7:55 am by Jerri Lynn Ward, J.D.
Nursing facility providers must continue to bill all other PASRR durable medical equipment (DME) using the existing billing information provided below. [read post]
19 Feb 2016, 1:42 pm by Steven Boutwell
  Certified nurse midwives are not authorized to conduct face-to-face encounters required for medical supplies, equipment, and appliances; nor are they included in the list of NPPs for purposes of DME orders. [read post]
17 Feb 2016, 6:46 am by Green and Associates
The latest one involves the former owner and operator (husband and wife) of a durable medical equipment (DME) supply company based in Long Beach, California. [read post]
8 Feb 2016, 7:35 am by Debra A. McCurdy
  CMS explains that it is aligning the timing and scope of the Medicaid medical equipment face-to-face encounter requirements with the parallel rules for Medicare durable medical equipment (DME). [read post]
8 Feb 2016, 7:35 am by Debra A. McCurdy
  CMS explains that it is aligning the timing and scope of the Medicaid medical equipment face-to-face encounter requirements with the parallel rules for Medicare durable medical equipment (DME). [read post]
28 Jan 2016, 6:47 am by Eric Turkewitz
Griffen then did the defense medical exam (DME) — sometimes improperly called an independent medical exam (IME) — and issued a report. [read post]
20 Jan 2016, 7:29 am by Green and Associates
On January 12, 2015,  J and L Medical Services, LLC in Connecticut entered into a civil settlement agreement with the federal and state governments in which it will pay $600,000 to resolve allegations that it violated the federal and state False Claims Acts. [read post]
11 Jan 2016, 3:00 am by Debra A. McCurdy
The Centers for Medicare & Medicaid Services (CMS) has issued a final rule to require Medicare prior authorization (PA) for certain durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS) items that the agency characterizes as “frequently subject to unnecessary utilization. [read post]