DME MAC and A/B MAC Determination of ESRD Method Selection (Rev. 2487, 06-19-12)

by  Jared Staheli
June 17th, 2015

A. Method Selection and Form CMS-382

For services furnished prior to January 1, 2011, the beneficiary was required to complete Form CMS-382 to choose either Method I or Method II dialysis. Method I dialysis patients receive their home dialysis equipment and supplies from a dialysis facility. Method II patients chose to deal with a home dialysis supplier that is not a dialysis facility. Once a beneficiary made a method selection choice, the beneficiary or dialysis facility submitted the Form CMS-382 to the appropriate FI. The FI then processed information from the form to CWF. Chapter 8 provided the instructions for completing the form.

For dates of service prior to January 1, 2011, the DME MACs deny Method II claims where there is no method selection or the method selection has a value of '1' on file at CWF.

For dates of service on and after January 1, 2011, please refer to Section 30.8.3 for information on the elimination of Method II home dialysis.

B. Changes in Method Selection

Prior to the implementation of the ESRD PPS, for dates of service prior to January 1, 2011, if a beneficiary decided to change his or her choice of method selection, he or she filled out a new Form CMS-382 to indicate the change. The beneficiary could have filled out a new method selection form at any time, but in most circumstances, the change did not take effect until January 1 of the following calendar year. If a beneficiary requested an exception to the January 1 implementation date in writing from the FI, the FI could have chosen to grant his or her request. See Chapter 8 for related requirements.

The DME MAC systems must be able to interpret the CWF trailer record that contains the method effective date.

For dates of service on and after January 1, 2011, please refer to Section 30.8.3 for information on the elimination of Method II home dialysis.

References:

DME MAC and A/B MAC Determination of ESRD Method Selection (Rev. 2487, 06-19-12). (2015, June 17). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/dme-mac-and-a-b-mac-determination-of-esrd-method-selection-rev-2487-06-19-12-26702.html

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