It does amaze me that CMS is using durable medical equipment numbers from 1986 (yes you read that right) to make a determination of what is appropriate now. In 2014. -------------------------------------------------- >>DME and accessories used in conjunction with DME are paid for under the DME benefit and in accordance with the rules at section 1834(a) of the Act. The Medicare definition of routinely purchased durable medical equipment (DME) set forth at 42 CFR §414.220(a)(2) specifies that routinely purchased equipment means equipment that was acquired by purchase on a national basis at least 75 percent of the time during the period July 1986 through June 1987. A review of expensive items that have been classified as routinely purchased equipment since 1989, that is, new codes added to the HCPCS after 1989 for items costing more than $150, showed inconsistencies in applying the definition. As a result, a review of the definition of routinely purchased DME was published in the Federal Register (CMS-1526-F) along with notice of DME items (codes) requiring a revised payment category. Also in the rule, CMS established that DME wheelchair accessories that are capped rental items furnished for use as part of a complex rehabilitative power wheelchair (wheelchair base codes K0835 – K0864) are payable under the lump sum purchase method. The complex rehabilitative power wheelchair base codes and options/accessories are payable under the lump sum purchase method set forth at 42 CFR §414.229(a)(5) and section 1834(a)(7)(A)(iii) of the Act
Posted on: Fri, 21 Mar 2014 20:22:50 +0000
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