Issues Under Review

CMS Approved Audit Issues



Issue Name: Oxygen Accessories
Issue Number A000332009
Issue Description: A potential issue may exist if certain oxygen accessories are billed when an oxygen system rental has been billed in the month prior to the date of service or in the subsequent month. Therefore, an issue may exist when these accessories are billed and reimbursed under Medicare Part B in this manner.
Type of Review Automated Review for Overpayments
State(s) Affected: DC, CT, MA, MD, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: DME Suppliers
Date Posted: February 17, 2010
Dates of Service: October 1, 2007 - Present
Issue References LCD L11468; LCD Policy Article A33768


Issue Name: MS-DRG Validation for MS-DRGs with Ventilator Support of 96+ Hours (At this time, Medical Necessity is excluded from review.)
Issue Number A000302009
Issue Description: DRG Validation requires that diagnostic and procedural information and the discharge status of the beneficiary, as coded and reported by the hospital on its claim, matches both the attending physician description and the information contained in the beneficiary's medical record. Reviewers will validate for MS DRGs 003, 004, 207, 870, 927 and 933; principal diagnosis, secondary diagnosis, and procedures affecting or potentially affecting the DRG.
Type of Review DRG Validation
State(s) Affected: DC, CT, MA, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: Inpatient Hospitals
Date Posted: January 19, 2010
Dates of Service: October 1, 2007 - Present
Issue References ICD-9-CM Coding Manual (for dates of service on claim), ICD-9-CM Addendums and Coding Clinics, PIM Ch 6.5.3, Section A - C - DRG Validation Review, DRG Desk Reference Ingenix 2009. CodeWrite, April 2007; AHIMA



Issue Name: MS-DRG Validation for MS-DRG 189 Pulmonary Edema & Respiratory Failure (At this time, Medical Necessity is excluded from review.)
Issue Number A000352009
Issue Description: DRG Validation requires that diagnostic and procedural information and the discharge status of the beneficiary, as coded and reported by the hospital on its claim, matches both the attending physician description and the information contained in the beneficiary's medical record. Reviewers will validate for MS-DRG 189, principal diagnosis, secondary diagnosis, and procedures affecting or potentially affecting the DRG.
Type of Review DRG Validation
State(s) Affected: DC, CT, MA, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: Inpatient Hospitals
Date Posted: January 19, 2010
Dates of Service: October 1, 2007 - Present
Issue References ICD-9-CM Coding Manual (for dates of service on claim), ICD-9-CM Addendums and Coding Clinics, PIM Ch 6.5.3, Section A - C - DRG Validation Review, OIG Report DRG 87: Pulmonary Edema and Respiratory Failure, August 1989



Issue Name: MS-DRG Validation for MS-DRGs for Tracheostomy (At this time, Medical Necessity is excluded from review.)
Issue Number A000362009
Issue Description: DRG Validation requires that diagnostic and procedural information and the discharge status of the beneficiary, as coded and reported by the hospital on its claim, matches both the attending physician description and the information contained in the beneficiary's medical record. Reviewers will validate for MS DRGs 003, 004, 011, 012, 013; principal diagnosis, secondary diagnosis, and procedures affecting or potentially affecting the DRG.
Type of Review DRG Validation
State(s) Affected: DC, CT, MA, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: Inpatient Hospitals
Date Posted: January 19, 2010
Dates of Service: October 1, 2007 - Present
Issue References ICD-9-CM Coding Manual (for dates of service on claim), ICD-9-CM Addendums and Coding Clinics, PIM Ch 6.5.3 A-C DRG Validation Review; UHDDS - Reporting of Inpatient Data Elements, July 31, 1985, Federal Register (Vol. 50, No. 147), Pages 31038-31040



Issue Name: Ambulance Unbundled Services During an Inpatient Hospital Stay
Issue Number A00062009
Issue Description: Ambulance services should be billed to the inpatient provider for services for inpatients. Therefore, an issue may exist when a beneficiary received ambulance services during an inpatient stay, which have been billed and reimbursed under Medicare Part B.
Type of Review Automated Review for Overpayments
State(s) Affected: DC, CT, MA, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: Ambulance Providers
Date Posted: January 07, 2010
Dates of Service: October 1, 2007 - Present
Issue References Internet Only Manual, Medicare Benefit Policy Manual Publication 100-02 Chapter 10, Section 10 and 10.3.3. Internet Only Manual, Medicare Processing Manual, Publication 100-04, Chapter 3, Sections 10.4 and 10.5. Internet Only Manual, Medicare Claims Processing Manual, Publication 100-04, Chapter 15, Section 10.2, Summary of Benefit and 30.A, Modifier specific to Ambulance Services.



Issue Name: Solid Insert with Seat or Back Wheelchair Cushions
Issue Number A000262009
Issue Description: Code E0992 (solid seat insert) is not separately payable when provided with a seat or a seat back wheelchair cushion. Therefore an issue may exist when E0992 is billed and reimbursed under Medicare Part B with a seat or seat back wheelchair cushion.
Type of Review Automated Review for Overpayments
State(s) Affected: DC, CT, MA, MD, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: DME Suppliers
Date Posted: December 22, 2009
Dates of Service: October 1, 2007 - Present
Issue References LCD Policy Article A17918



Issue Name: Lower Limb Suction Valve Prosthesis
Issue Number A000252009
Issue Description: Codes L5647 and L5652 describe a modification to a prosthetic socket that incorporates a suction valve in the design. The items described by these codes are not components of a suspension locking mechanism (L5671). Therefore, an issue may exist when such a locking mechanism is billed and reimbursed under Medicare Part B along with a suction valve suspension.
Type of Review Automated Review for Overpayments
State(s) Affected: DC, CT, MA, MD, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: DME Suppliers
Date Posted: December 22, 2009
Dates of Service: October 1, 2007 - Present
Issue References LCD Policy Article A25310, Region A DMERC PSC Bulletin



Issue Name: Prosthetic Additions with Initial or Preparatory Knee Prosthesis
Issue Number A000282009
Issue Description: When an initial below knee prosthesis (L5500) or a preparatory below knee prosthesis (L5510-L5530, L5540) is provided, prosthetic substitutions and/or additions of procedures and components are covered in accordance with the functional level assessment, except for certain codes. Therefore, an issue may exist when these codes are billed and reimbursed under Medicare Part B with such a prosthesis.
Type of Review Automated Review for Overpayments
State(s) Affected: DC, CT, MA, MD, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: DME Suppliers
Date Posted: December 22, 2009
Dates of Service: October 1, 2007 - Present
Issue References LCD Policy L11464



Issue Name: Multiple DME Rentals within a Month
Issue Number A000042009
Issue Description: Certain procedure codes may not be billed in conjunction with other procedure codes for the same date of service and for the same beneficiary. Therefore an issue may exist when these codes are billed and reimbursed under Medicare Part B on the same date of service and for the same beneficiary.
Type of Review Automated Review for Overpayments
State(s) Affected: DC, CT, MA, MD, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: DME Suppliers
Date Posted: December 22, 2009
Dates of Service: October 1, 2007 - Present
Issue References CMS Pub 100-04, Ch 20, § 30.1, 30.2, 30.5, 30.7, 130.8, Social Security Act, Volume I, Title XVIII, Section 1834



Issue Name: Headrest with a Power Operated Vehicle or a Power Wheelchair with a Captain's Chair Seat
Issue Number A000272009
Issue Description: Headrests (E0955) may not be billed on the same date of service as a Power Operated Vehicle (POV) or Power Wheelchair (PWC) with a captain's chair seat. Therefore, an issue may exist when a beneficiary receives a Power Operated Vehicle (POV) or Power Wheelchair (PWC) with a captain's chair seat and a headrest, which has been billed and reimbursed under Medicare Part B, on the same date of service.
Type of Review Automated Review for Overpayments
State(s) Affected: DC, CT, MA, MD, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: DME Suppliers
Date Posted: December 22, 2009
Dates of Service: October 1, 2007 - Present
Issue References LCD Policy L15845



Issue Name: Wheel Attachment with New Non-Wheeled Walker
Issue Number A000292009
Issue Description: Wheel attachment (E0155) cannot be paid on the same day or within one month of the initial issue of a nonwheeled walker. Therefore, an issue may exist when a beneficiary receives this wheel attachment, which has been billed and reimbursed under Medicare Part B, within a month of an initial issue of a nonwheeled walker.
Type of Review Automated Review for Overpayments
State(s) Affected: DC, CT, MA, MD, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: DME Suppliers
Date Posted: December 22, 2009
Dates of Service: October 1, 2007 - Present
Issue References LCD Policy L11472



Issue Name: Clinical Social Worker (CSW) Services
Issue Number A000222009
Issue Description: CSW services rendered during an inpatient acute care or skilled nursing facility stay are not separately payable under Medicare Part B, instead they are included in the facility’s Prospective Payment System (PPS) payment. CSW providers are expected to render services under arrangement with the facility. Therefore, an issue may exist when a beneficiary received CSW services during an inpatient stay, which have been billed and reimbursed under Medicare Part B.
Type of Review Automated Review for Overpayments
State(s) Affected: MA, ME, NH, RI, VT
Providers Affected: CSW Providers
Date Posted: December 11, 2009
Dates of Service: October 1, 2007 - Present
Issue References Medicare Benefit Policy Manual: Pub 100-02, Ch 15, § 170. CMS MedLearn Matters Article #: SE0439.



Issue Name: Pharmacy Supply and Dispensing Fees
Issue Number A000052009
Issue Description: Pharmacy supply and dispensing fees when billed by a DME supplier are required to be accompanied with an oral anti-cancer, oral anti-emetic, immunosuppressive drug or inhalation drug. The absence of one of the aforementioned drugs billed on the same date of service or a denial of one of the aforementioned drugs represents a potential issue.
Type of Review Automated Review for Overpayments
State(s) Affected: DC, CT, MA, MD, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: DME Suppliers
Date Posted: September 18, 2009
Dates of Service: October 1, 2007 - Present
Issue References Internet Only Manual 100-04 (Medicare Claims Processing Manual), Chapter 17 (Drugs and Biologicals), Section 80.7. Transmittal 754, Change Request 3990, Requirement 3990.15. DME MAC Jurisdiction A Article for Nebulizers A24944 (LCD L11499). DME MAC Jurisdiction A Article for Oral Anticancer Drugs A25227 (LCD L5057). DME MAC Jurisdiction A Article for Oral Antiemetic Drugs A25228 (LCD L5058). DME MAC Jurisdiction A Article for Immunosuppressive Drugs A23662 (LCD L11531).



Issue Name: Wheelchair Bundling
Issue Number A000202009
Issue Description: A potential issue may exist if certain procedure codes are billed in conjunction with other procedure codes for the same date of service and the same beneficiary.
Type of Review Automated Review for Overpayments
State(s) Affected: DC, CT, MA, MD, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: DME Suppliers
Date Posted: September 18, 2009
Dates of Service: October 1, 2007 - Present
Issue References LCD L11473, CMS Pub 100-03, Ch 1, § 280.1 & 280.3



Issue Name: Urological Bundling
Issue Number A000192009
Issue Description: A potential issue may exist if certain urological procedure codes are billed in conjunction with other urological procedure codes for the same date of service and same beneficiary.
Type of Review Automated Review for Overpayments
State(s) Affected: DC, CT, MA, MD, ME, DE, NJ, NY, NH, PA, RI, VT
Providers Affected: DME Suppliers
Date Posted: September 18, 2009
Dates of Service: October 1, 2007 - Present
Issue References CMS Pub.100-3, Ch1, § 230.17; LCD L5080 LCD Policy Article 25230