As AOPA reported earlier, CGS, the current Jurisdiction C DME MAC contractor, was awarded the Jurisdiction B contract on September 3, 2015. However, National Government Services (NGS), the current Jurisdiction B DME MAC, filed a formal protest causing CMS to halt the transition pending a review of the contract award by the Government Accountability office […]
O&P industry leaders returned from the January 8-10 2nd O&P Leadership Conference in Palm Beach with comments such as “by far, the most valuable event I’ve had the privilege to attend in my career”, “truly a great session”, and “extremely helpful”. With a lineup including former Senator Bob Kerrey, Political Analyst Charles E. Cook, Jr. and Healthcare Futurist […]
On December 16, 2015, the Centers for Medicare and Medicaid Service (CMS) announced that Noridian HealthCare Solutions, LLC. was awarded a contract to serve as the Jurisdiction A Durable Medical Equipment Medicare Administrative Contractor (DME MAC). Noridian currently holds contracts to serve as the Jurisdiction D DME MAC as well as the Pricing, Data Analysis, […]
On December 29th, the Centers for Medicare and Medicaid Services (CMS) released the long anticipated final rule regarding Medicare prior authorization of certain DMEPOS, including most lower limb prostheses. The final rule, which will be published in the December 30, 2015 Federal Register, will be implemented 60 days after it publication. AOPA has reviewed the […]
AOPA’s commitment to O&P research has resulted in an increase of funding to pilot grants, systematic reviews, and other special projects. The protocol for a recently funded systematic review is available to read now. This is an increasingly relevant topic: it presents a systematic review now underway of outcomes of dysvascular partial foot amputation and how […]
The Pricing, Data Analysis and Coding contractor (PDAC) has announced that due to a change in the 2016 descriptor verbiage for L1902 and L1904, it will initiate a new coding verification for any ankle gauntlet style devices that contain joints that are currently listed on the PDAC site under L2999. Read the announcement. It is […]
AOPA is pleased to announce that the first Mastering Medicare: Essential Coding & Billing Techniques Seminar will be in Tampa, Florida January 25-26 at the Tampa Marriott Westshore. AOPA experts provide the most up-to-date information to help O&P Practitioners and office billing staff learn how to code complex devices, including repairs and adjustments, through interactive discussions […]
On November 23, 2015, the Centers for Medicare and Medicaid Services (CMS) released the 2016 Medicare DMEPOS fee schedule. As expected, Medicare fees for orthotic and prosthetic devices will be slightly lower in 2016 than they were in 2015. The annual update to the Medicare O&P fee schedule is based on a combination of the […]
It has been remarkably quiet on the Recovery Audit Contractor (RAC) front for the last 18 months or so. As a result of the original RAC contracts coming to an end and new RAC contract proposals being submitted and reviewed, the number of additional documentation requests (ADRs) has been reduced significantly. CMS advised its original […]
The Centers for Medicare and Medicaid Services (CMS) has released the new HCPCS codes for 2016. There were no L-codes added or deleted for 2016. There were two minor verbiage changes for codes L1902 and L1904, which describe pre-fabricated and custom fabricated ankle gauntlet style devices respectively. Below is a breakdown of the code descriptor […]
