tci Medicare Compliance & Reimbursement - 2005 Issue 26

DME: Suppliers Moving Closer To Ambulation Standard

Mind the gap between NCD's effective and implementation dates.The Centers for Medicare and Medicaid Services has ordered the durable medical equipment regional carriers to discard the old bed- or chair-confined standard for determining medical necessity for mobility assistive equipment and instead use the functional ambulation standard set forth in the May 5 National Coverage Determination. Heads up: But a two-month difference between the policy's effective date and its implementation date could cause headaches for suppliers. "I'm glad CMS followed through because we were hearing from DMERCs that they weren't going to apply the new coverage determination...

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