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This chapter provides general instructions on billing and claims processing for durable medical equipment (DME), prosthetics and orthotics (P&O), parenteral and enteral nutrition (PEN), and supplies. Coverage requirements are in the Medicare Benefit Policy Manual and the National Coverage Determinations Manual.
laboratory procedures or tests require Food and Drug Administration (FDA) approval before coverage is provided. A diagnostic laboratory test is considered a laboratory service for billing purposes, regardless of whether it is performed in: • A physician’s office, by an independent laboratory;
28 Μαρ 2019 · Please refer to NCCI for correct coding guidelines and specific applicable code combinations prior to billing Medicare. Refer to the NCDs for the procedure code list of ICD-10-CM codes that are considered covered by Medicare at: https://www.cms.gov/Medicare/Coverage/CoverageGenInfo/LabNCDsICD10.html
DME is covered by Medicare Part-B & includes various services like physician visits, laboratory tests, surgical procedures in addition to equipment like walkers & wheelchairs, crutches, special hospital beds etc.
DME IN TRADITIONAL MEDICARE. OBTAINING MEDICARE-COVERED DME – GENERALLY. • Ask the prescriber to recommend suppliers they know and have worked with before. • At https://www.medicare.gov/medical-equipment-suppliers/ enter beneficiary zip code, then... Locate the covered item or service on the list.
Section 1: What’s Durable Medical Equipment (DME)? About this booklet. This booklet explains Original Medicare coverage of DME and what you might need to pay. DME is reusable medical equipment. It includes items like: • Home oxygen equipment. • Hospital beds. • Walkers. • Wheelchairs. Words in blue are defined on pages 17–18.
This Medicare Learning Network ® (MLN) fact sheet explains how Medicare pays for Clinical Diagnostic Laboratory Tests (CDLTs) and Advanced Diagnostic Laboratory Tests (ADLTs) under the Clinical Laboratory Fee
