decisionhealth Newsletters, Coder Pink Sheets - 2007 Issue 4 (April)
DME: Physicians won't have to bid to provide crutches, canes
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Article Overview
This article explains Medicare’s 2007 durable medical equipment competitive bidding rule and how it affects physician practices, especially orthopedics. It covers which DME items are excluded from bidding at first, how geographic phase-in affects payment, the role of accreditation, and the broader transition plan for future expansion. The article also highlights orthopedic DME utilization data and discusses how the rule intersects with billing for commonly supplied items.
Why This Topic Matters
It helps physicians, orthopedic practices, and medical coders understand how Medicare’s DME competitive bidding changes may affect supplier status, payment, and compliance planning. The piece is relevant for practices that furnish DME and need to track Medicare implementation timing and accreditation requirements.
Article Sections
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Competitive bidding rollout and exempt items
Overview of Medicare’s new durable medical equipment competitive bidding program, including the initial categories addressed and the planned geographic phase-in. Also covers items described as not immediately subject to bidding and the general payment implications of the rule.
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Accreditation requirement and implementation timing
Discussion of accreditation expectations for suppliers, the timing of implementation in initial metropolitan areas, and the broader Medicare schedule for expansion to additional regions.
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Why you should care
General explanation of how the policy change may affect physician practices that furnish DME, including billing and operational considerations.
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Most costly items to be bid first
Summary of the criteria CMS used to identify initial DME categories for bidding and the types of items expected to be included early in the program.
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Heads up: You may have to bid to provide braces, boots and other orthotics
Discussion of later expansion concerns involving orthotics and how the article relates the rule to broader Medicare and Stark law context.
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Durable medical equipment billed most frequently by orthopedists
A utilization-oriented table of DME items commonly billed by orthopedists, together with supporting Medicare data and bidding-exemption status.
What You Will Learn
- How Medicare’s durable medical equipment competitive bidding program was being phased in
- Which broad categories of DME were addressed in the initial rollout
- Why accreditation became relevant for suppliers and physician practices
- How the article frames the impact on orthopedic and other specialty practices
- What kinds of DME utilization data were highlighted for orthopedists
Who Should Read This
- Physicians
- Orthopedic practices
- Medical coders
- DME suppliers
- Practice administrators
Codes Discussed
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