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Durable Medical Equipment (DME): Coding & Billing for Hospitals & Physicians Ensuring Compliance

Tuesday, September 15, 2009

9:30am - 11:00am
Webinar

$249 MHA Member Rate
$349 Non-Member Rate

Register Online
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Objectives: At the completion of this program, the participant will be able to:

  1. Discuss the concept of true DME versus implantable DME and devices
  2. Explain how DME is classified under the Medicare program
  3. Discuss the DMEPOS fee schedule and payment for DME
  4. Identify the purpose, functions and process of being a DME supplier
  5. Describe the process of filing the CMS-855-S for enrollment as a DME supplier
  6. List who can bill what DME and to whom the DME should be billed
  7. Review the various Level II HCPCS codes for DME
  8. Appreciate Medicare's extreme compliance concerns concerning incorrect payment for DME
  9. Review specific compliance concerns relative to dispensing DME
  10. Explain how both hospitals and physicians become involved with DME
PROGRAM TOPICS

DMEPOS – What Is It?

  • Definition of DME
  • Categorization and Classification of DME
  • Sources for Information
  • Payment System Interfaces
  • Compliance Overview – False Claims
  • DMEPOS Fee Schedule

• Coding And Billing for DME

  • DME Billable by Physicians To Carriers
  • DME Billable by Hospitals To Fiscal Intermediaries
  • DME Billable Only To DMERCs
  • Level II HCPCS Codes
  • Charge Master Setup
  • Common Items for Hospitals
  • Common Items for Physicians/Clinics
  • Implantable Devices, DME and APCs
  • Prosthetics/Orthotics – PT/OT Interface
  • 2-Day DRG Rule for DME

• Administrative/Organizational Concerns

  • Obtaining a Provider Number
  • CMS Form 855-S – Key Elements
  • Dispensing Location Concept
  • DME Closet Concept - ED
  • Associated DME Companies
  • Freedom of Choice Concept
  • Inpatient DME Suppliers
  • Under Arrangement DME Supplier
  • Alternative Approaches

• Examples/Case Studies

  • Physicians Dispensing DME
  • Hospital ED Dispensing Crutches/Canes/Walkers
  • PT/OT Custom Splinting – Therapy-Only Codes
  • PT/OT – Prosthetic/Orthotics
  • Wheelchair Clinics

• Compliance Considerations

  • False Claim Act
  • Fraud, Abuse and Anti-Kickback
  • Repair Versus Warranty
  • Developing Written Policies & Procedures
 

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MHA Education Department
5 New England Executive Park
Burlington, MA 01803-5096