Incarcerated or Unlawfully Present in the U.S. Claim Rejections (U538H, U538Q)

Obtaining Beneficiary Eligibility Information Through NGSConnex

Obtaining Beneficiary Eligibility Information Through NGSConnex  As a reminder, our Customer Service Representatives aren’t permitted to share eligibility information because it’s available through NGSConnex. If you need help, we [...]

Practitioners: Are You Ordering Nebulizers and Inhalation Medication for Your Patient?

Practitioners: Are You Ordering Nebulizers and Inhalation Medication for Your Patient? Medicare will consider coverage of a nebulizer, compressor and related accessories when the patient’s medical record verifies that the patient has a [...]

Physicians: Are You Ordering Glucose Monitors and Supplies for Your Patients?

Physicians: Are You Ordering Glucose Monitors and Supplies for Your Patients? The CERT program has noted claim errors for glucose monitors. The following information is provided to assist you in reducing these types of errors. Medicare will [...]

Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)

Durable Medical Equipment, Prosthetics, Orthotics and Supplies To help providers and suppliers gain a better understanding of the roles of billing, coverage, documentation requirements and medical necessity when providing DMEPOS to Medicare [...]

Clinicians: Are You Ordering PAP Devices and Related Accessories for Your Patients?

Clinicians: Are You Ordering PAP Devices and Related Accessories for Your Patients? Medicare can make payment for PAP devices and related accessories when the patient’s medical record shows the patient has OSA and meets medical documentation, [...]

Practitioners: Are You Ordering Spinal Orthoses for Your Patient?

Practitioners: Are You Ordering Spinal Orthoses for Your Patients? The DME MACs are providing helpful guidance to assist the supplier in providing a spinal orthosis to your patient. Medicare must be able to verify there is supporting medical [...]

Clinicians: Are You Ordering Oxygen for Your Patient?

Clinicians: Are You Ordering Oxygen for Your Patient? Home use of oxygen and oxygen equipment is eligible for Medicare reimbursement only when a beneficiary meets all of the requirements set out in the CMS IOM, Publication 100-03, Medicare [...]