Archive for DME Medicare compliance
Medicare’s Pricing, Data Analysis and Coding (PDAC) has revised it’s original review of the Moore Balance Brace and determined the HCPCS codes to use for billing to be:
- L1940 - ankle foot orthosis, molded to patient, plastic
- L2820 - addition to lower extremity orthoss, soft interface for molded plastic, below knee section
- L2330 - addition to lower extremity orthosis, lacer molded to patient model, for custom fabricated orthoses only.
The 2012 maximum allowable fees for these codes are:
- L1940 $571.10
- L2820 $100.28
- L2330 $453.44
Medicare fees vary by state so go to www.dmepdac.com to determine the specific allowable amounts for your patients.
The Moore Balance Brace is commonly prescribed bilaterally to address risk factors contributory to increased risk of falling. Frequently determined diagnoses that might benefit from the stability afforded by the MBB include:
- Muscle weakness (728.87)
- Ataxia, muscular incoordination (781.3)
- Gait abnormality/ staggering, ataxic (781.2)
- Osteoarthritis, localized primary ankle & foot (715.17)
- Arthropathy, unspecified, ankle and foot (716.97)
- Pain in joint, ankle, foot (719.47)
- Instability of joint, ankle & foot (718.87)
- Dropfoot (736.79)
- Hemiplegia (438.20)
For additional information about the Moore Balance Brace and fall prevention please contact SafeStep at 866.712.STEP (7837) or email firstname.lastname@example.org.
Navigating the DME Medicare Compliance jungle isn’t always easy, but rest assured SafeStep has you covered. We offer a free training module, Essentials of Medicare DME Compliance for AFOs, to ensure you are compliant on every level when dispensing and billing AFO treatment.
From the comfort of your office or home, you can choose the best time to view this informative webinar.
Upcoming dates throughout the month of October are now available for registration.
For more information, please visit the SafeStep free training page below and view the Essentials of Medicare DME Compliance for AFOs module.
Do you have questions on shoe fitting, fall prevention or even Medicare Compliance? Along with our blog and separate articles, SafeStep hosts an interactive forum to discuss questions and news of our industry.
Did you know what key features of the Moore Balance Brace help improve balance when recommending a shoe style?
Find out the answer here on our SafeStep Forum:
Do you have a question regarding certifying physican documents for qualifying condition on shoes?
Find out the answer on our SafeStep forum:
Wonder if there’s a question you’re thinking about on our forum, now’s a good time to head over to the forum and find out. On our forum, not only can you see answers, you can participate in the discussions.
While you’re there, why not let your colleagues know about how they can interact with other industry thought leaders? To register and start conversing, simply go to the following web address:
Good day, for today’s post, we have a question on compliance, DME and Surety bond requirements. The question and answer, I believe are valuable and need sharing here on the SafeStep blog. As always, if you have questions or ideas for future content published here, please contact us.
Question: I am applying to dispense DME after a 4-year hiatus. There’s a great deal of language regarding “surety bonds” and “accreditation” in the application. I cannot, after much research, decipher whether I need to have one or both of these. If so, how would I obtain either one?
Answer: Physicians are exempt at this time (it will be up to the Secretary of HHS to determine if this exemption will change) from both the accreditation and surety bond requirements IF they are suppliers of DMEPOS to their patients, and not setting up commercial retail-type DME and supply businesses. Commercial suppliers need to comply with both the accreditation and surety bond requirements.
Being exempt from accreditation and surety bond requirements does not exempt physicians from the DME standards.
For more information, go to:
As of July 15, 2008, DPMs, recognized as physicians by CMS, are exempt from facility accreditation and surety bond requirements.
If you practice using a tax ID number, you must obtain a Type 2, organizational NPI number. After your DME supplier number has been obtained from National Government Services, you need an 835 CEDI form that will enable online viewing of electronic remittance notices and offer a way to set up for electronic direct deposits.