Program_Memos / 2003 / B-03-028

Why This Topic Matters

It clarifies how Medicare expected DMERC claims to be processed when diagnosis coding requirements, claim edits, and supplier documentation did not perfectly align. The memo is useful for understanding the administrative expectations around claim submission, validation, and education during the 2003 update period.

Article Sections

1. Change Request

   Introduces the memorandum and the general subject area involving DMERC claim processing and diagnosis coding guidance.

2. Background

   Provides the policy context for ICD-9-CM diagnosis reporting under HIPAA and the electronic claim transaction requirements discussed in the memo.

3. Policy

   Summarizes the coding and claim-submission expectations described by CMS for durable medical equipment and related claims administration.

4. Provider Education

   Describes dissemination and training expectations for communicating the guidance to suppliers and other stakeholders.