by Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
December 4th, 2014
Joint DME MAC/PDAC Publication
The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have evaluated the MyoPro® upper extremity assist device and determined that it falls within the Durable Medical Equipment (DME) benefit category. Claims for MyoPro® should be submitted using the DME miscellaneous code E1399.
Suppliers are reminded that when submitting claims for items coded E1399, the supplier must include the following information:
- Manufacturer name
- Model name or number
- Pricing information
- Explanation of medical necessity
This information must be entered in the narrative field of an electronic claim (NTE 2300 or NTE 2400 of an electronic claim) or Item 19 of a paper claim.
Claims for this item will be reimbursed under the capped-rental payment methodology as it does not meet the requirements to be classified as an inexpensive or routinely purchased item.
For questions about correct coding, contact the PDAC Contact Center at (877) 735-1326 during the hours of 8:30 a.m. to 4:00 p.m. CT, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form.
Date Posted 12/03/14