decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2002 / B-02-014
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Article Overview
This article explains a CMS program memorandum directed to Medicare contractors about processing emergency home dialysis supply claims for Method II beneficiaries. It covers the operational background, claims handling changes, implementation timing, provider education, and related systems coordination for dialysis billing under HCPCS. The piece is most relevant to Medicare billing staff, DMERC operations, dialysis suppliers, and revenue cycle professionals working with ESRD home dialysis claims.
Why This Topic Matters
The memorandum addresses how Medicare contractors were expected to handle emergency reserve dialysis supplies after a change in coding and billing structure. It is useful for understanding the scope of the policy update, the affected HCPCS items, and the implementation timeline that shaped claims processing.
Article Sections
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Scope
Introduces the purpose of the memorandum and the systems area affected by the change.
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Background
Summarizes the Medicare home dialysis setting, the Method I and Method II supply arrangements, and the operational context for emergency reserve supplies.
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Policy
Describes the general payment policy framework and the systems coordination expected for emergency reserve supply processing.
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Implementation
Outlines the contractor and systems actions required, including the affected HCPCS items, timing, claims handling, and related processing instructions.
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Provider Education
Addresses how contractors were instructed to communicate the change to suppliers and through scheduled outreach channels.
What You Will Learn
- The Medicare context for emergency home dialysis supplies in Method II billing.
- The types of contractor and systems updates discussed in the memorandum.
- The implementation timeline and provider education considerations associated with the change.
- Which general HCPCS item group was affected by the policy update.
Who Should Read This
- Medicare contractors
- DMERC operations staff
- Dialysis suppliers
- Medical billing and coding professionals
- Revenue cycle teams supporting ESRD claims
Codes Discussed
Modifiers Discussed
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