DME MAC Supplier Manual by Chapters

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Chapter Title	Contents
Foreword *Revised*	Foreword
Chapter 1: General Information	The Medicare Program The Medicare Card The Common Working File Deductible and Coinsurance The CMS Internet-Only Manuals Printer-friendly version Top of Index
Chapter 2: Enrollment Process Revised	National Provider Identifier Obtaining and Retaining Medicare DMEPOS Billing Privileges Change of Information Directory of Medicare Suppliers Supplier Standards Change of Ownership Resources Available to Assist Suppliers with the Enrollment Process Printer-friendly version Top of Index
Chapter 3: Medicare DMEPOS Competitive Bidding Program Revised	Overview Competitive Bidding Implementation Contractor Delay of the Medicare DMEPOS Competitive Bidding Program Additional Information Printer-friendly version Top of Index
Chapter 4: Participation Program Revised	Enrollment Benefits of Participation Assignment of Claims Printer-friendly version Top of Index
Chapter 5: Coordination of Benefits Contractor	Coordination of Benefits Contractor Medicare’s Role Medicare Secondary Payer Programs CMS MSP Questionnaire Billing Requirements Claim Liability Calculation Medicare Secondary Payer Overpayments Printer-friendly version Top of Index
Chapter 6: Medical Policy Information Revised	General Medical Policy Information Current DMEPOS Medical Policies Printer-friendly version Top of Index
Chapter 7: Certificates of Medical Necessity/DME MAC Information Forms Revised	Overview DME Forms External Infusion Pumps and Enteral/Parenteral Nutrition CMN/DIF Completion Instructions Cover Letters HCPCS Codes Requiring a CMN or a DIF Printer-friendly version Top of Index
Chapter 8: Documentation/Break in Service/Break in Billing Revised	Orders Certificates of Medical Necessity Documentation in the Patient's Medical Record Proof of Delivery Requirements Requests for Additional Information Printer-friendly version Top of Index
Chapter 9: Advance Determination of Medicare Coverage Revised	Eligible Items Submitting ADMC Requests ADMC Requirements ADMC Determination Printer-friendly version Top of Index
Chapter 10: Advance Beneficiary Notice of Coverage Revised	General Guidelines Limitation on Liability Upgrades Advance Beneficiary Notice of Noncoverage Completion Printer-friendly version Top of Index
Chapter 11: Claim Filing Jurisdiction Revised	Claim Filing Based on Beneficiary Address Disposition of Incorrectly Filed Claims Durable Medical Equipment Medicare Administrative Contractors DME MAC Jurisdiction Map Printer-friendly version Top of Index
Chapter 12: Claim Submission	Acceptable Claim Formats Claim Filing Time Limits Signature on File Requirements Ordering Claim Forms Ordering Information CMS-1500 Hints and Tips New Revised CMS-1500 Claim Form (Version 08-05) Sample CMS-1500 Claim Form (Version 08- 05) CMS-1500 Claim Form (Version 08-05) Field Descriptions and Instructions Mailing Address Resources Printer-friendly version Top of Index
Chapter 13: Electronic Data Interchange Revised	Electronic Media Claims Administrative Simplification Compliance Act Common Electronic Data Interchange Electronic Format How to Become an Electronic Submitter Front-End Edit Report Electronic Remittance Advice Electronic Funds Transfer Claim Status Inquiry/Beneficiary Eligibility Jurisdiction B DME MAC EDI Help Desk E-Commerce Consultants National Government Services Web Site Listserv E-Commerce Connection Printer-friendly version Top of Index
Chapter 14: Level II HCPCS Codes and HCPCS Modifiers Revised	Level II HCPCS Codes HCPCS Modifiers The Pricing, Data Analysis, and Coding Contractor Printer-friendly version Top of Index
Chapter 15: DMEPOS Payment Categories Revised	Inexpensive or Other Routinely Purchased DME Items Requiring Frequent and Substantial Servicing Customized Items Other Prosthetic and Orthotic Devices Transcutaneous Electrical Nerve Stimulators Parenteral and Enteral Nutrition Pumps Home Dialysis Supplies Sample ESRD-382 Form Capped Rental Items Sample Rent/Purchase Option for Electric Wheelchairs Letter Oxygen and Oxygen Equipment Repairs, Maintenance and Replacement Printer-friendly version Top of Index
Chapter 16: Pricing Revised	Fee Schedules Reasonable Charges Drug Pricing Individual Consideration Inherent Reasonableness Printer-friendly version Top of Index
Chapter 17: Medicare Benefit and Denial Categories	Benefit Categories Denial Categories Prevention of Common Claim Submission Errors Printer-friendly version Top of Index
Chapter 18: Supplier Remittance Notice	General Information Tips for Reading the Remittance Notice Sample Remittance Notice Remittance Notice Key Resources Printer-friendly version Top of Index
Chapter 19: Medicare Summary Notice	Sample MSN Summary of Numbered Fields on Sample MSN Resources Printer-friendly version Top of Index
Chapter 20: Reopenings and Appeals Revised	Reopenings for Minor Errors and Omissions Appeals Sample Jurisdiction B DME MAC Request for Redetermination Form Sample Jurisdiction B DME MAC Reconsideration Request Form Sample Form CMS - 1696 Appointment of Representative Printer-friendly version Top of Index
Chapter 21: Overpayments Revised	DME MAC Initiated Demand Letters The Offset Process Immediate Offset by Fax Sample Jurisdiction B DME MAC ORU Offset Request Form Supplier Voluntary Refunds Sample Jurisdiction B DME MAC ORU Voluntary Refund Form Change of Address Printer-friendly version Top of Index
Chapter 22: Customer Care	Interactive Voice Response Unit Customer Care Contact Center Telephone Inquiries Written Inquiries Printer-friendly version Top of Index
Chapter 23: Resources Revised	Jurisdiction B DME MAC Contact Information Jurisdiction B DME MAC Forms Index Acronyms Printer-friendly version Top of Index