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DME Billing and Medicare

CPS, C-EMR, PM

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Anonymous

(@Anonymous)

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We have recently converted to CPS and I would appreciate anyone's wisdom on a Medicare DME billing issue. With our prior incantation (NextGen->GatewayEDI) we've been successfully billing and being reimbursed for Splints without any issues for many, many years. After our recent conversion to Centricity we've been unable to make our way through to a payment.

The problem rests with what must be entered in box 32 when you specificy the service location as 12 (Home). We have always left box 32 empty and been paid just fine. Noridian - Jurisdiction D told me this morning that they are happy with either box 32 being blank or our office address(location where we provided the splint.)

Unfortunately, this is counter to what is being implemented in Centricity which has a plug-in for 5010 edits which requires that the patients address (including 9-digit zip)be entered into box 32 if location 12 is specified. We've never collected patient 9-digit zips, nor been asked to in the past, heck I don't even know my own.

I'd be interested in what other's are doing. Are you indeed billing with patient address & 9-digit zips? Is there an easy way to retrieve 9-digit zips from addresses?

Any guidance would be appreciated! Regards, Mike

Posted : February 4, 2014 5:03 am

angelahunsberger

(@angelahunsberger)

Posts: 290

Reputable Member

maibindert said:

We have recently converted to CPS and I would appreciate anyone's wisdom on a Medicare DME billing issue. With our prior incantation (NextGen->GatewayEDI) we've been successfully billing and being reimbursed for Splints without any issues for many, many years. After our recent conversion to Centricity we've been unable to make our way through to a payment.

The problem rests with what must be entered in box 32 when you specificy the service location as 12 (Home). We have always left box 32 empty and been paid just fine. Noridian - Jurisdiction D told me this morning that they are happy with either box 32 being blank or our office address(location where we provided the splint.)

Unfortunately, this is counter to what is being implemented in Centricity which has a plug-in for 5010 edits which requires that the patients address (including 9-digit zip)be entered into box 32 if location 12 is specified. We've never collected patient 9-digit zips, nor been asked to in the past, heck I don't even know my own.

I'd be interested in what other's are doing. Are you indeed billing with patient address & 9-digit zips? Is there an easy way to retrieve 9-digit zips from addresses?

Any guidance would be appreciated! Regards, Mike

Hi Mike, I'd like to try and help you through this. Email me and we can setup a time to look at this together. [email protected]

Posted : February 5, 2014 12:43 am

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