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Calling Charlene!!!

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jcbilling:
I need some DME expertise for a second...I have a prospective client that is a supplier for wheelchairs (manual & electric), walkers, hospital beds, oxygen, etc. I am familiar with DME billing, but not these items. I've done CPM rentals, mastectomy supplies, lymphadema pumps and a few other little items. Is there anything that differs greatly with these items. The client is in Region B - and since they have a lot of Medicare customers, I know I can go to their supplier manual and find specific guidelines on their website. Any suggestions for billing for this type of equioment?

Thanks,
Charity

Pay_My_Claims:
you will require ADMC approval, you will also need to make sure you check for same or similar equipment. We use vision share to check the CMN status on clients first instead of having to call. There are items that are considered included in the cost of the base that you must be aware of. Also the non-covered items. with power chairs the e1028  can only bill so many units so , and the LCD's on the cushions. The modifiers are needed when you do the rental items. KX is used often, and know when to use the KE modifier. email me anytime if you need assistance

Good blessings

jcbilling:
Forgive my ignorance, but what does ADMC stand for? We wiil be using Brightree, which can check the same or similiar and also track our CMN's. I will have to look into the KX and KE modifier...never used those before.

Thanks,
Charity

Michele:
Advanced Determination of Medicare Coverage

Pay_My_Claims:

--- Quote from: jcbilling on September 24, 2010, 06:07:09 PM ---Forgive my ignorance, but what does ADMC stand for? We wiil be using Brightree, which can check the same or similiar and also track our CMN's. I will have to look into the KX and KE modifier...never used those before.

Thanks,
Charity

--- End quote ---

Oh...Brightree software or Brightree just the Medicare free eligibility verification (because that does not check for same or similar). There is a cheat sheet for when to use the KE modifier depending on which base you are billing.  Brightree is VERY EXPENSIVE. its a good software system, we have contemplated using it, but when you consider the cost its not necessary depending on the size and extent of the company you are billing for. ADMC as stated below in meaning, you have to obtain that from Medicare, to determine if you meet the criteria for the equipment. ADMC is not required on all equipment. They are divided into group 1, 2, 3 for power chairs, then you have your capped rentals, scooters, and lift chairs. Medicare will only pay for the mechanism, not the chair itself. Anyway email me if you have questions. I will be more than happy to help you. Good blessings on the new client

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