CGS updates FAQ on Philips recall

YARMOUTH, Maine – CGS has updated its FAQ on the Philips recall, adding two new questions and revising three questions.

The two new questions are:

If a beneficiary with a patient-owned recalled device refuses warranty support or chooses to purchase a replacement device out of pocket, will the DME MACs honor an executed ABN that holds the beneficiary responsible for replacement (outside of warranty) as same or similar to equipment previously purchased be Medicare?

The DME MACs will honor a properly executed ABN. The voluntary recall does not modify any of the CMS Reasonable Useful Lifetime regulations.

Will we be able to bill Medicare using K0462 if we supply a customer with an alternate unit to use while they are waiting for Philips to repair/replace the unit that is patient owned and it could take several months to get a repair/replacement? Can the DME MACs allow K0462 to be billed for more than one month given the expectation that the repairs will take several months based on volume?

Billing a rental unit under K0462 is allowed; however, suppliers should make every effort to minimize the time that a rental unit is utilized while awaiting repair. This may include working with the treating practitioner to substitute a different brand/model not impacted by the voluntary recall. For billing K0462, suppliers should enter “Philips recall” with the brand/model number impacted and date purchased.

CGS clarified question 5 that applies to devices still under capped rental, clarified question 9 and added information to question 10 from the U.S. Food and Drug Administration.
CGS originally posted the FAQ on July 16.