CMS Documentation Requirements for Durable Medical Equipment

Event Information
Product Format
Prerecorded Event
Lynn M. Anderanin, CPC, CPMA, CPPM, CPC-I, COSC
60 minutes
Product Description

Meeting CMS Documentation Requirements for DME to Avoid Overpayments and Recoupments in Medicare

One thing you need to get right if you’re looking for Medicare pay for your durable medical equipment (DME) supplies is your documentation. CMS has very specific guidelines for proving medical necessity for DME for your patients, and not meeting those could not only result in payment losses but could put you at risk for audits. 

Take the guesswork out of your guideline compliance. Join this informative session with expert speaker Lynn M. Anderanin and learn what needs to be in patients’ records to  demonstrate medical necessity. Lynn will share advice on proper HCPCS coding, sample forms you can use, and explain what’s needed to ensure CMS guideline compliance.

Session Highlights:

  • Using the Pricing, Data Analysis and Coding tool for proper HCPCS code assignment
  • Understand what types of DME require a detailed written order and what should be included in this order
  • Proof of delivery and patient signature requirements
  • Modifiers mandated by Medícare DME coding guidelines
  • Know what is needed on your checklist to identify whether all documentation is available
  • Should you be audited
  • What to do about returning payments

 Session Snapshots:

  • Stark Law
  • CMS Program Integrity Manual – Chapter 5
  • Orders
    • Dispensing
    • Detailed written order
  • Medical Necessity statement
  • Medical records
  • Proof of delivery
  • Advance Beneficiary Notice (ABN)
  • Modifiers
    • RT/LT
    • KX
    • KT-KY
    • KT-KV
    • KW-KY
  • Coverage modifiers
  • DME terminology
  • CMS definition of Brace
  • L code reimbursement

Who should attend?

  • Managers
  • Administrators
  • Physicians
  • Physical therapists
  • Occupational therapists
  • Podiatrists
  • Coders
  • Billers
  • Orthopedics and Podiatry professionals

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About Our Speaker

Lynn Anderanin - Orthopedic Guidelines Expert for ICD 10

Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, is the  Sr. Director of Coding Education for Healthcare Information Services, a physicians revenue cycle management company. She has over 35 years experience in all areas of the physician practice, and specializes in Orthopaedics.  Lynn is currently a  workshop and audio presenter. She is a  former member of the American Academy of Professional Coders (AAPC) National Advisory Board, and has served...   More Info
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