Posts by Noel Neil

COMPLIANCE CORNER UPDATE The Pricing Data Analysis and Coding Contractor (PDAC), Palmetto GBA, submitted a request to revise HCPCS Level II code E1028 and establish three new HCPCS Level II codes to further identify wheelchair mounting hardware accessories. Palmetto GBA further requested HCPCS Level II code E1028 be revised to account for any type of…

In October 2024, the OIG announced a new oxygen audit titled “Medicare Payments to Suppliers for Oxygen and Oxygen Equipment.” According to the OIG, “For calendar year 2023, Medicare paid more than $674 million for oxygen and oxygen equipment. CMS has consistently identified high rates of improper payment for oxygen and oxygen equipment through its…

It is the time of the year when the National Provider Enrollment (NPE) Contractors will start mailing letters or post cards to all suppliers, notifying you of your ability to change your participation status with Medicare. This is an important reminder to suppliers to ensure their mailing address is updated in PECOS. A returned mail…

Centers for Medicare and Medicaid Services (CMS) approved the creation of two off-the-shelf (OTS) codes that previously only had “custom fitted” code. Prior to the creation of the new codes, suppliers furnishing off-the-shelf equivalent of HCPCS code L1820 Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and…

Effective November 14, 2024 The Medicare DME MACs jointly announced the Retirement of Pneumatic Compression Devices (PCD) Local Coverage Determination (LCD) and Related Policy Article – Effective November 14, 2024. With the retirement of the LCD and Policy Article, providers and suppliers should refer to the CMS  National Coverage Determination (NCD) – Pneumatic Compression Devices (280.6) which addresses…

ACU-Serve has played an integral role in ensuring that Medicare policies, particularly those that are diagnosis-specific, remain up to date with the latest ICD-10-CM codes that meet the clinical indications of these policies. Through ongoing collaboration with DME MACs and industry stakeholders, ACU-Serve has successfully initiated the addition of the following ICD-10-CM codes to the…

Dear Supplier, Every three years, Centers for Medicare and Medicaid Services (CMS) requires suppliers to revalidate their Medicare enrollment information. Suppliers are required to either update or confirm all their information in their records, including but not limited to practice location, surety bond, and insurances. CMS usually posts revalidation dates 6-7 months in advance of…

At ACU-Serve, we are committed to providing accurate and compliant billing services for those we serve. Recently, an issue has come to our attention regarding the billing of Medicare for the mask interface (pillow or cushion) that comes packaged with the mask. After careful review, ACU-Serve believes that suppliers should not bill Medicare separately for the…

Do you know failing to collect or failing to document a “reasonable collection effort” to collect the Medicare deductible, and/or coinsurance may violate Federal Anti-Kickback Statue (AKS), Beneficiary (Patient) Inducement Statute and False Claim Act (FCA)? According to Chapter 23 of the Claims Processing Manual section 80.8.1 (CPM), “Physicians or suppliers who routinely waive the…