Канал: Noridian Medicare DME

Written Order Prior to Delivery (WOPD) and Face-to-Face (F2F) Requirements

Written Order Prior to Delivery (WOPD) and Face-to-Face (F2F) Requirements

Spinal Orthoses: Coverage Criteria

Spinal Orthoses: Coverage Criteria

Pneumatic Compression Devices: Documentation

Pneumatic Compression Devices: Documentation

Participating vs Non Participating

Participating vs Non Participating

Parenteral Nutrition: Billing

Parenteral Nutrition: Billing

Oxygen: Maintenance and Service

Oxygen: Maintenance and Service

Off-the-Shelf (OTS) vs Custom Fit Orthoses

Off-the-Shelf (OTS) vs Custom Fit Orthoses

Knee Orthoses: Prefabricated

Knee Orthoses: Prefabricated

Ankle-Foot and Knee-Ankle-Foot Orthoses (AFO/KAFO)

Ankle-Foot and Knee-Ankle-Foot Orthoses (AFO/KAFO)

Remittance Advice

Remittance Advice

Prior Authorization: Billing, Modifiers, and Medicare Secondary Payer (MSP)

Prior Authorization: Billing, Modifiers, and Medicare Secondary Payer (MSP)

Negative Pressure Wound Therapy (NPWT): Ulcer Definitions

Negative Pressure Wound Therapy (NPWT): Ulcer Definitions

Negative Pressure Wound Therapy (NPWT): Documentation

Negative Pressure Wound Therapy (NPWT): Documentation

Negative Pressure Wound Therapy (NPWT): Coding and Utilization

Negative Pressure Wound Therapy (NPWT): Coding and Utilization

Negative Pressure Wound Therapy (NPWT): After Month Four

Negative Pressure Wound Therapy (NPWT): After Month Four

Nebulizer, Compressor, and Accessories

Nebulizer, Compressor, and Accessories

Multi-Function Ventilator

Multi-Function Ventilator

Medicare Secondary Payer (MSP) Liability Billing Situations

Medicare Secondary Payer (MSP) Liability Billing Situations

Medicare Secondary Payer (MSP)

Medicare Secondary Payer (MSP)

Medicare Learning Network (MLN) Products

Medicare Learning Network (MLN) Products

Manual Wheelchair: Upgrades

Manual Wheelchair: Upgrades

Manual Wheelchair: Bases

Manual Wheelchair: Bases

L200 Surgical Dressings: Part 1

L200 Surgical Dressings: Part 1

Request for Refills

Request for Refills

Parenteral Nutrition: Coding

Parenteral Nutrition: Coding

KX Modifier

KX Modifier

Knee Orthoses: Custom Fabricated

Knee Orthoses: Custom Fabricated

Intermittent Catheterization: Coverage Criteria

Intermittent Catheterization: Coverage Criteria

Inhalation Drugs Dispensing Fee

Inhalation Drugs Dispensing Fee

Indwelling Catheters: Coverage Criteria

Indwelling Catheters: Coverage Criteria

Hospital Beds: Upgrades

Hospital Beds: Upgrades

Hospital Beds: Coverage Criteria

Hospital Beds: Coverage Criteria

Gradient Compression Stockings and Wraps: Coverage Criteria

Gradient Compression Stockings and Wraps: Coverage Criteria

Glucose Monitors and Supplies L200: Orders

Glucose Monitors and Supplies L200: Orders

Glucose Monitors and Supplies L200: Modifiers

Glucose Monitors and Supplies L200: Modifiers

Glucose Monitors and Supplies: Overutilization

Glucose Monitors and Supplies: Overutilization

Glucose Monitors and Supplies: Documentation

Glucose Monitors and Supplies: Documentation

Fraud and Abuse: Abuse

Fraud and Abuse: Abuse

External Infusion Pumps: Modifiers

External Infusion Pumps: Modifiers

Enteral Nutrition: Coding

Enteral Nutrition: Coding

DME Replacement

DME Replacement

CMS-1500 Form

CMS-1500 Form

Beneficiary Authorization

Beneficiary Authorization

Appeals: Redeterminations

Appeals: Redeterminations

Upper Limb Orthoses

Upper Limb Orthoses

Prior Authorization: Orthoses

Prior Authorization: Orthoses

Coverage Criteria for Oral Antiemetic Drugs When Used as a Replacement for IV Antiemetics

Coverage Criteria for Oral Antiemetic Drugs When Used as a Replacement for IV Antiemetics

How to Pass a Medical Review

How to Pass a Medical Review

High Frequency Chest Wall Oscillation Device (HFCWO)

High Frequency Chest Wall Oscillation Device (HFCWO)

Gradient Compression Stockings and Wraps: Coding

Gradient Compression Stockings and Wraps: Coding

Glucose Monitors and Supplies L200: High Utilization

Glucose Monitors and Supplies L200: High Utilization

Getting To Know Noridian

Getting To Know Noridian

Electronic Submission of Medical Documentation (esMD)

Electronic Submission of Medical Documentation (esMD)

DMEPOS Benefit Categories

DMEPOS Benefit Categories

Custom Fabricated Orthoses

Custom Fabricated Orthoses

Continued Use and Continued Need

Continued Use and Continued Need

Appeals: Completing the Redetermination Form

Appeals: Completing the Redetermination Form

Automatic External Defibrillator (AED): K0606

Automatic External Defibrillator (AED): K0606

A1-A9 Modifiers

A1-A9 Modifiers

Basic Inhalation Solution Information

Basic Inhalation Solution Information

Common Electronic Data Interchange (CEDI)

Common Electronic Data Interchange (CEDI)

Competitive Bid - Round 2021 Off-the-Shelf (OTS) Back and Knee Braces

Competitive Bid - Round 2021 Off-the-Shelf (OTS) Back and Knee Braces

Continuous Passive Motion (CPM) Devices

Continuous Passive Motion (CPM) Devices

External Breast Prosthesis (EBP): Modifiers, Upgrades, and Documentation

External Breast Prosthesis (EBP): Modifiers, Upgrades, and Documentation

External Infusion Pump (EIP): Insulin Pump

External Infusion Pump (EIP): Insulin Pump

Home Health Agency (HHA)

Home Health Agency (HHA)

Hospice

Hospice

Oral Anticancer Drugs: Coverage Criteria

Oral Anticancer Drugs: Coverage Criteria

Oxygen: Coding and Billing Guidelines

Oxygen: Coding and Billing Guidelines

Pneumatic Compression Devices: Chronic Venous Insufficiency

Pneumatic Compression Devices: Chronic Venous Insufficiency

Pressure Reducing Support Surface (PRSS) Group 1: Coverage

Pressure Reducing Support Surface (PRSS) Group 1: Coverage

Prior Authorization: Lower Limb Prosthetics

Prior Authorization: Lower Limb Prosthetics

RT and LT Modifiers

RT and LT Modifiers

Seat Lift Mechanisms

Seat Lift Mechanisms

Transcutaneous Electrical Nerve Stimulators (TENS): Coverage Criteria

Transcutaneous Electrical Nerve Stimulators (TENS): Coverage Criteria

Upgrades

Upgrades

Urological Supplies: Coding and Billing

Urological Supplies: Coding and Billing

Wound Suction Pumps

Wound Suction Pumps

Types of Orders for DMEPOS Items

Types of Orders for DMEPOS Items

Therapeutic Shoes for Persons with Diabetes: Documentation Requirements

Therapeutic Shoes for Persons with Diabetes: Documentation Requirements

Therapeutic Shoes for Persons with Diabetes: Coverage Criteria

Therapeutic Shoes for Persons with Diabetes: Coverage Criteria

Therapeutic Shoes for Persons with Diabetes: Certifying, Prescribing, and Supplier Roles

Therapeutic Shoes for Persons with Diabetes: Certifying, Prescribing, and Supplier Roles

Surgical Dressings: Refill Requirements

Surgical Dressings: Refill Requirements

Standard Written Order (SWO)

Standard Written Order (SWO)

Proof of Delivery

Proof of Delivery

Ventilators

Ventilators

Pressure Reducing Support Surface (PRSS) Group 2: Coverage

Pressure Reducing Support Surface (PRSS) Group 2: Coverage

Parenteral Nutrition: Coverage Criteria

Parenteral Nutrition: Coverage Criteria

Orthotics: Same or Similar

Orthotics: Same or Similar

Noncovered DMEPOS Items

Noncovered DMEPOS Items

Intravenous Immune Globulin (IVIG) Billing in 2024

Intravenous Immune Globulin (IVIG) Billing in 2024

External Breast Prosthesis (EBP) Coverage, Refills, Replacements

External Breast Prosthesis (EBP) Coverage, Refills, Replacements

Lymphedema Compression Treatment Items

Lymphedema Compression Treatment Items

Intake Process

Intake Process

GA, GZ, GX, EY, and GY Modifiers

GA, GZ, GX, EY, and GY Modifiers

External Infusion Pump (EIP): Inotropic Drugs Coverage Criteria

External Infusion Pump (EIP): Inotropic Drugs Coverage Criteria

Enteral Nutrition: Billing and Documentation

Enteral Nutrition: Billing and Documentation

Enteral Nutrition: Administration

Enteral Nutrition: Administration

Cervical Traction Devices: Coverage Criteria

Cervical Traction Devices: Coverage Criteria

Before You Bill

Before You Bill

Targeted Probe and Educate (TPE)

Targeted Probe and Educate (TPE)

Switching from Positive Airway Pressure to Respiratory Assist Device for Treatment of OSA

Switching from Positive Airway Pressure to Respiratory Assist Device for Treatment of OSA

Supplier Reminders

Supplier Reminders

Respiratory Assist Devices (RAD) Continued Coverage Beyond the First Three Months

Respiratory Assist Devices (RAD) Continued Coverage Beyond the First Three Months

Respiratory Assist Device (RAD) Entering Medicare and Reasonable Useful Lifetime (RUL) Requirements

Respiratory Assist Device (RAD) Entering Medicare and Reasonable Useful Lifetime (RUL) Requirements

Appeals: Levels of Appeals

Appeals: Levels of Appeals

Advance Beneficiary Notice of Noncoverage (ABN)

Advance Beneficiary Notice of Noncoverage (ABN)

Power Mobility Devices (PMDs): Supplier Assistive Technology Professional (ATP) Involvement

Power Mobility Devices (PMDs): Supplier Assistive Technology Professional (ATP) Involvement

Navigating Noridian's Website

Navigating Noridian's Website

L200 Surgical Dressings: Part 2

L200 Surgical Dressings: Part 2

Prior Authorization: Beneficiary Address Change

Prior Authorization: Beneficiary Address Change

Power Mobility Device (PMD): Home Assessment

Power Mobility Device (PMD): Home Assessment

Pneumatic Compression Devices: Lymphedema

Pneumatic Compression Devices: Lymphedema

Pneumatic Compression Devices: Lymphedema Extending onto Chest, Trunk and/or Abdomen

Pneumatic Compression Devices: Lymphedema Extending onto Chest, Trunk and/or Abdomen

Ostomy Supplies

Ostomy Supplies

Osteogenesis Stimulators: Coverage Criteria

Osteogenesis Stimulators: Coverage Criteria

Transcutaneous Electrical Nerve Stimulator (TENS): Billing, Coding, and Documentation

Transcutaneous Electrical Nerve Stimulator (TENS): Billing, Coding, and Documentation

Oral Appliance Devices

Oral Appliance Devices

Navigating the Medicare Coverage Database

Navigating the Medicare Coverage Database

Mechanical In-Exsufflation Devices

Mechanical In-Exsufflation Devices

Prior Authorization: Power Mobility Device (PMD)

Prior Authorization: Power Mobility Device (PMD)

Oxygen: Testing Requirements

Oxygen: Testing Requirements

Glucose Monitors and Supplies: Coverage

Glucose Monitors and Supplies: Coverage

Comprehensive Error Rate Testing (CERT)

Comprehensive Error Rate Testing (CERT)

Skilled Nursing Facility (SNF) Consolidated Billing

Skilled Nursing Facility (SNF) Consolidated Billing

Same or Similar

Same or Similar

Osteogenesis Stimulators: Billing and Coding

Osteogenesis Stimulators: Billing and Coding

Fraud and Abuse: Fraud

Fraud and Abuse: Fraud

Dear Physician Prescribing Home Oxygen

Dear Physician Prescribing Home Oxygen

Claim Denial Rebill, Reopen, or Redeterminations

Claim Denial Rebill, Reopen, or Redeterminations

Accessories and Supplies Used with Beneficiary-Owned Equipment

Accessories and Supplies Used with Beneficiary-Owned Equipment

Positive Airway Pressure (PAP) L200: Scenario 2

Positive Airway Pressure (PAP) L200: Scenario 2

Oxygen: Coverage Guidelines

Oxygen: Coverage Guidelines

Break in Service/Break in Need

Break in Service/Break in Need

Local Coverage Determinations (LCD) and Policy Articles (PA)

Local Coverage Determinations (LCD) and Policy Articles (PA)

Wheelchair Seating: Coverage Criteria

Wheelchair Seating: Coverage Criteria

Tips for Successful Interactive Voice Response (IVR) Use

Tips for Successful Interactive Voice Response (IVR) Use

$Refractive Lenses: Beneficiary Preference Items$

Refractive Lenses: Beneficiary Preference Items

Positive Airway Pressure (PAP) L200: Scenario 3

Positive Airway Pressure (PAP) L200: Scenario 3

Positive Airway Pressure (PAP) L200: Scenario 1

Positive Airway Pressure (PAP) L200: Scenario 1

Oxygen: Maintenance and Service

Oxygen: Maintenance and Service

Manual Wheelchair Home Assessment

Manual Wheelchair Home Assessment

Continuous Glucose Monitors and Supplies on or after January 1, 2023

Continuous Glucose Monitors and Supplies on or after January 1, 2023

Advance Determination of Medicare Coverage (ADMC)

Advance Determination of Medicare Coverage (ADMC)

Concurrent Use of Oxygen and Positive Airway Pressure (PAP)

Concurrent Use of Oxygen and Positive Airway Pressure (PAP)

Claims During Public Health Emergency (PHE) CR Modifier and COVID-19 Narrative

Claims During Public Health Emergency (PHE) CR Modifier and COVID-19 Narrative

Power Mobility Devices (PMDs) Documentation

Power Mobility Devices (PMDs) Documentation

Front End Edits: Claim Rejections

Front End Edits: Claim Rejections

Enteral Nutrition: Coverage Criteria

Enteral Nutrition: Coverage Criteria

$Refractive Lenses: Coverage$

Refractive Lenses: Coverage

Other Medicare Contractors

Other Medicare Contractors

Commodes: Coverage Criteria

Commodes: Coverage Criteria

Cervical Traction Devices: Coding and Billing Reminders

Cervical Traction Devices: Coding and Billing Reminders

Respiratory Assist Device (RAD): Initial 12-Week Coverage Guidelines

Respiratory Assist Device (RAD): Initial 12-Week Coverage Guidelines

Orthoses: Repairs and Replacements

Orthoses: Repairs and Replacements

Pneumatic Compression Devices: Coding

Pneumatic Compression Devices: Coding

Place of Service

Place of Service

Paperwork Documentation Supporting Claims (PWK)

Paperwork Documentation Supporting Claims (PWK)

Fee Schedule Payment Categories

Fee Schedule Payment Categories

Noridian's Role as a DME Medicare Administrative Contractor (MAC)

Noridian's Role as a DME Medicare Administrative Contractor (MAC)

Negative Pressure Wound Therapy (NPWT): Coverage Criteria

Negative Pressure Wound Therapy (NPWT): Coverage Criteria

Urological Supplies: Drainage Systems

Urological Supplies: Drainage Systems

The Structure of Medicare

The Structure of Medicare

Power Mobility Device (PMD): Captain’s Chair vs Solid/Sling Back/Base Chair

Power Mobility Device (PMD): Captain’s Chair vs Solid/Sling Back/Base Chair

Orthopedic Footwear

Orthopedic Footwear

$Refractive Lenses: Progressive Lenses Upgrade$

Refractive Lenses: Progressive Lenses Upgrade

$Refractive Lenses: Deluxe Frames Upgrade$

Refractive Lenses: Deluxe Frames Upgrade

$Refractive Lenses: Coding and Documentation$

Refractive Lenses: Coding and Documentation

Entering Medicare with Equipment Retained from a Prior Payer

Entering Medicare with Equipment Retained from a Prior Payer

Speech Language Pathologist (SLP) Evaluation for Speech Generating Device (SGD)

Speech Language Pathologist (SLP) Evaluation for Speech Generating Device (SGD)

Prior Authorization (PA): Group 2 Pressure Reducing Support Surface (PRSS)

Prior Authorization (PA): Group 2 Pressure Reducing Support Surface (PRSS)

Manual Wheelchair K0001-K0003 Scenarios L200

Manual Wheelchair K0001-K0003 Scenarios L200

Lower Limb Prostheses (LLP): Replacements

Lower Limb Prostheses (LLP): Replacements

Lower Limb Prostheses (LLP): Repairs

Lower Limb Prostheses (LLP): Repairs

Hospital Beds and Accessories: Coding and Coverage

Hospital Beds and Accessories: Coding and Coverage

Functional Level Modifiers (K0-K4)

Functional Level Modifiers (K0-K4)

Eye Prosthesis

Eye Prosthesis

Speech Generating Devices (SGDs): Coverage Criteria

Speech Generating Devices (SGDs): Coverage Criteria

Lower Limb Prostheses (LLP): Physician and Prosthetist Records

Lower Limb Prostheses (LLP): Physician and Prosthetist Records

Gastric Suction Pumps

Gastric Suction Pumps

Tracheostomy Care or Cleaning Starter Kits

Tracheostomy Care or Cleaning Starter Kits

Pressure Reducing Support Surfaces (PRSS) Group 1: Coding

Pressure Reducing Support Surfaces (PRSS) Group 1: Coding

Pressure Reducing Support Surfaces (PRSS): Ulcer Stages

Pressure Reducing Support Surfaces (PRSS): Ulcer Stages

Pre-Claim Hotline Overview

Pre-Claim Hotline Overview

Five Criteria for Immunosuppressive Drugs

Five Criteria for Immunosuppressive Drugs

Automatic External Defibrillator (AED): E0617

Automatic External Defibrillator (AED): E0617

Prior Authorization: Submitting a Request Package and Expedited Requests

Prior Authorization: Submitting a Request Package and Expedited Requests

Prior Authorization: Program Overview

Prior Authorization: Program Overview

Prior Authorization: Noridian Medicare Portal (NMP) Submission

Prior Authorization: Noridian Medicare Portal (NMP) Submission

Prior Authorization: Affirmative and Non-Affirmative Decisions

Prior Authorization: Affirmative and Non-Affirmative Decisions

Pressure Reducing Support Surface (PRSS) Group 2: Coding

Pressure Reducing Support Surface (PRSS) Group 2: Coding

Pressure Reducing Support Surface (PRSS) Group 2: Billing Reminders

Pressure Reducing Support Surface (PRSS) Group 2: Billing Reminders

Pressure Reducing Support Surface (PRSS) Group 1: Billing Reminders

Pressure Reducing Support Surface (PRSS) Group 1: Billing Reminders

Tracheostomy Care Supplies

Tracheostomy Care Supplies

Pressure Reducing Support Surfaces (PRSS): Denials Due to Provider Medical Records

Pressure Reducing Support Surfaces (PRSS): Denials Due to Provider Medical Records

Hospital Beds: Coding

Hospital Beds: Coding

Lower Limb Prostheses: Coverage Criteria

Lower Limb Prostheses: Coverage Criteria

Provider Enrollment, Chain and Ownership System (PECOS)

Provider Enrollment, Chain and Ownership System (PECOS)

Hospital Beds and Accessories: Billing Reminders

Hospital Beds and Accessories: Billing Reminders

Heating Pads and Heat Lamps: Coding

Heating Pads and Heat Lamps: Coding