Tag: Documentation
In brief: Vent correction, Medtrade ‘Insider,’ documentation update
October 9, 2024HME News Staff
CAMBRIDGE, Mass. – Philips Respironics has issued a voluntary correction for Trilogy Evo, Trilogy Evo O2, Trilogy Evo Universal and Trilogy EV300 ventilators regarding the use of in-line nebulizers.
The company has determined that, in some circumstances, the use of in-line nebulizers placed in certain locations may lead to aerosol deposits forming over time on the ventilator flow sensor. Should this occur, there is a possibility of patient impact due to one or more of the following...
Noridian updates medical records requirements
October 7, 2024HME News Staff
WASHINGTON – In the event of a claim review, information contained directly in the contemporaneous medical record is the source required to justify payment, except as noted elsewhere for prescriptions, according to an update posted by Noridian Healthcare Solutions. The medical record is not limited to records from treating physician/practitioner offices but may include records from hospitals, nursing facilities, home health agencies and other health care professionals. Records from suppliers...
In brief: Sign-on letter for oxygen, BOC’s Certificant of the Year
July 19, 2023HME News Staff
WASHINGTON – Reps. Terri Sewell, D-Ala., and Adrian Smith, R-Neb., are collecting signatures for a sign-on letter asking CMS to accept the standard written order as the only necessary documentation to establish medical necessity for audits of home oxygen, sleep and non-invasive ventilation claims submitted during the public health emergency, according to AAHomecare.
The letter asks CMS to protect patient access by instructing contractors to use CMS’s widely accepted oxygen...
Reps. Sewell, Smith launch sign-on letter to protect access to oxygen
July 17, 2023HME News Staff
WASHINGTON – Reps. Terri Sewell, D-Ala., and Adrian Smith, R-Neb., are collecting signatures for a sign-on letter asking CMS to accept the standard written order as the only necessary documentation to establish medical necessity for audits of home oxygen, sleep and non-invasive ventilation claims submitted during the public health emergency, according to AAHomecare.
The letter asks CMS to protect patient access by instructing contractors to use CMS’s widely accepted...
CMS expands required list
January 17, 2023HME News Staff
WASHINGTON – CMS has added 10 more HCPCS codes to a required list for a face-to-face encounter /written order prior to delivery, according to VGM Government Relations.
The new codes include the following for back, knee and ankle/foot braces: L0631, L1843, L1932, L1940, L1951, L1960, L1970, L2005, L2036. Also included: E0748, osteogenesis stimulator, electrical, non-invasive, spinal applications.
The effective date for the news codes is April 2023.
The required...
Oxygen sign-on letter heads to CMS
August 11, 2022HME News Staff
WASHINGTON – Twenty two members of the House of Representatives have asked CMS to streamline documentation for home oxygen therapy, AAHomecare reports. A sign-on letter spearheaded by Reps. Terri Sewell, D-Ala., and Larry Bucshon, R-Ind., requests that CMS: “Use the opportunity of expanding the current National Coverage Determination for oxygen to establish a clear set of criteria to support medical necessity and instruct the contractors to rely solely on the Standard Written Order...
Regulatory update: DME MACs notified, RACs limited
February 15, 2022HME News Staff
WASHINGTON – CMS on Feb. 10 published a change request notifying the DME Medicare Administrative Contractors of the agency’s new national coverage determination for home oxygen therapy.
CMS notes the following changes are effective for claims with dates of service starting Sept. 27, 2021:
expansion of oxygen coverage for acute and chronic conditions;
expansion of coverage for short and long-term need (when hypoxemia exhibited);
the ability of the MACs...
CQRC: Contact CMS about paperwork requirements
January 3, 2022HME News Staff
WASHINGTON – The Council for Quality Respiratory Care is asking industry stakeholders to contact CMS Administrator Chiquita Brooks-LaSure to standardize the paperwork requirements for home oxygen coverage.
The CQRC says requiring physicians to provide medical records could result in “the vast majority of claims being denied.”
“CMS has indicated that physicians will be required to provide their medical records instead of using a form with the information...
Industry on home oxygen: We need ‘objective standards for review’
October 5, 2021HME News Staff
WASHINGTON – AAHomecare, VGM & Associates, the Council for Quality Respiratory Care and 11 other organizations are asking CMS to eliminate the medical record review for home oxygen therapy and to accept the clinician prescription/standard written order as the required documentation for establishing medical necessity.
These changes would protect against fraud and abuse, reduce the burden on clinicians and suppliers, and protect access for Medicare beneficiaries, the groups say in an...
DME MACs drop CMNs for oxygen, infusion services
May 12, 2020HME News Staff
WASHINGTON - The DME MACs on May 7 announced that they will not require CMNs for oxygen claims during the COVID-19 public health emergency.
The update follows CMS's decision not to enforce clinical indications of coverage for the oxygen NCDs and LCDs, as outlined in an April 6 interim final rule.
“After carefully reviewing the CMN and the related claims processing issues that would result from having missing information or having clinical information for which the form was intended,...