Tuesday, April 23, 2019

CMS bulks up PA program - HME News

Read the full article:  CMS bulks up PA program - HME News

"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. 
Additionally, CMS has added four codes for home oxygen therapy to the “master list” of codes potentially subject to prior authorization. Those codes are E1390, E0466, E0784 and L0650."

According to:

"This document announces the addition of four Healthcare Common Procedure Coding System (HCPCS) codes to the Master List of Items Frequently Subject to Unnecessary Utilization that could be potentially subject to Prior Authorization as a condition of payment."

"This update reflects the addition of four new items that meet the updated Payment Threshold that are listed in an OIG or GAO report of a national scope or a CERT DME and/or DMEPOS Service Specific Report(s)."

"HCPCS  Description
E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate.
E0466 Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell).
E0784 External Ambulatory infusion pump, insulin.
L0650 Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf."

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Home medical device retailers. California HMDR Exemptee online training certification class. Earns a course completion certificate accepted by the California Department of Public Health - Food and Drug Branch.
Home medical device retailers. California HMDR Exemptee online training certification class. Earns a course completion certificate accepted by the California Department of Public Health - Food and Drug Branch.


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