Coding & Reimbursement

Welcome to the AOPA’s Coding and Reimbursement center. Below you will find links to resources that are crucial for O&P related issues.

Centers for Medicare and Medicaid Services (CMS)

• CMS Homepage
• SNF Consolidated Billing
• DMEPOS Provider Page
• Medical Policies
• Medicare Manuals

DME MAC Jurisdictions

• DME MAC Jurisdiction A
• DME MAC Jurisdiction B
• DME MAC Jurisdiction C
• DME MAC Jurisdiction D

National Supplier Clearinghouse (NSC)

• NSC Homepage
• NSC Licensure Database
• DMEPOS Supplier Standards

Pricing, Data Analysis and Coding Contractor (PDAC)

• PDAC Home Page
• PDAC Product Classification List
• PDAC Advisory Articles
• Items Requiring PDAC Coding Verification

Recovery Audit Contractor (RAC)

• Region 5: DMEPOS, Home Health & Hospice Claims

Miscellaneous

• Medicare DMEPOS Medically Unlikely Edits Table
• Social Security Act, Title XVIII (Medicare)
• SNF PPS Exclusion List