The Centers for Medicare and Medicaid Services (CMS) has released the 2017 Medicare DMEPOS fee schedule which will be effective for Medicare claims with a date of service on or after January 1, 2017. The 2017 Medicare fee schedule for orthotic and prosthetic services will be increased by 0.7% over 2016 rates. The 0.7% increase […]
HHS OIG Releases 2017 Work Plan-Two Longstanding Objectives in Orthotics Remain; No Other/New Prosthetic or Orthotic Items Listed Each year, the HHS Inspector General releases its annual Work Plan, which lists the topics where the OIG believes there are significant potential items of fraud or other inappropriate or inefficient operations by HHS (including CMS and […]
GOP Runs the Table, Trump Wins Presidency, and Maintains Control of Both Senate and House In an election unprecedented in American history, Donald Trump defied the polls, conventional wisdom and notions of political correctness for a convincing win of the Presidency in the Electoral College, despite a roughly break even in the popular vote. What […]
The Centers for Medicare and Medicaid Services (CMS) has released the new HCPCS codes for 2017, and there were only a few minor changes. The biggest change was the deletion of the temporary K codes (K0901 & K0902), which became effective on October 1, 2014, to describe off the shelf (OTS) versions of custom fitted […]
As we reported in July, the Centers for Medicare and Medicaid Services (CMS), placed all the activities of four existing Recovery Audit Contractors (RAC) contractors on hiatus as a result of the upcoming award of new RAC contracts.This hiatus was to allow for a smooth transition to the new RAC contractors, including the single, national […]
Noridian, the Jurisdiction D Durable Medical Equipment Medicare Administrative Contractor (DME MAC), recently released their quarterly results of its review for claims involving the HCPCS codes L1832, L1843, L0648, L0650 and L4361. Between April 2016 and July 2016 Noridian reviewed 161 claims involving the L1832 and 152 claims were denied; resulting in a 99% error/denial […]
The Agency for Healthcare Research and Quality (AHRQ), the “government agency tasked with producing evidence to improve the quality of healthcare while working with partners to ensure that the evidence is understood and used” recently announced that it will be initiating a systematic review for lower limb prostheses. The systematic review will be performed through […]
AOPA has submitted comments on the publication entitled Technical Considerations for Additive Manufactured Devices: Draft Guidance for Industry and Food and Drug Administration Staff which was published in the Federal Register on May 10, 2016. AOPA submitted comments pertaining to additive manufacturing in the design and fabrication of external prosthetic components and orthotic devices, specifically through the use […]
Earlier this year, Medicare implemented a new policy on Comprehensive Care of Joint Replacement. While positioned as a pilot test, all hospitals were forced to be involved. Under this new program, hospitals are given financial incentives to reduce the total cost for hip and knee replacements. If hospitals succeed in driving down the total costs, […]
The four Durable Medical Equipment Medicare Administrative Contractors (DME MAC), recently released a joint correct coding bulletin reminding DMEPOS suppliers that it is each supplier’s responsibility to select the proper HCPCS codes for billing. To aid suppliers in their selection of the proper HCPCS code(s) the DME MACs provided the following tips: Check the PDAC […]
