Medical Billing Forum

Billing => Billing => : Antony sequeira June 12, 2014, 03:28:00 AM

: Difference in DME billing
: Antony sequeira June 12, 2014, 03:28:00 AM

Hi All,

I was trying to find out "how does DME billing differ from the regular Medical billing", i have been searching all over the internet but was not rewarding.

Thanks in advance.

Regards,
Antony Sequeira

: Re: Difference in DME billing
: Michele June 12, 2014, 01:47:02 PM

It doesn't necessarily differ any more than any specialty differs in that it is billed on CMS 1500's.  Every specialty has it's own quirks.  DME uses HCPCS codes instead of CPT codes but they use ICD9's for dx codes.  There are some other things too like rentals, etc.  that require special handling.  Many times the DME must be ordered by a physician.  I'm sure there are a lot of other things, but those are the most basic obvious differences that I see.

: Re: Difference in DME billing
: Antony sequeira June 13, 2014, 06:50:22 AM

Thank you Michele for the speedy answer :)

Antony

: Re: Difference in DME billing
: DMK June 13, 2014, 01:22:56 PM

I have to say that from all the posts I read regarding DME billing (I don't bill it, but I'm always trying to learn) it's all about having the right requests, authorizations, and delivery paper trails.  Since it's objects, not services, the paper trails and signatures along the way seem to be the biggest bugaboo.

: Re: Difference in DME billing
: kristin June 13, 2014, 09:24:03 PM

Another difference, and one that I see a lot of questions on in various forums, is that for Medicare patients, the claim does not go to the local MAC, it goes to the local DMERC for processing.

: Re: Difference in DME billing
: Michele June 16, 2014, 09:54:48 AM

Good point kristin!  I forgot to mention that.  That seems to be a concept that is hard for some to grasp. It's still Medicare but equipment is billed under DMERC.