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Durable Medical Equipment
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Durable Medical Equipment Billing Services

Every DME supplier faces challenges in coding and billing. Professional coding and billing expertise is necessary to code and bill DME claims. DME coding and billing is complex and requires experienced, trained and certified coders to accurately code the rentals and sales of equipments that provides therapeutic benefits to a patient in need. DME includes, but is not limited to, wheelchairs (manual and electric), traction equipment, canes, crutches, walkers, kidney machines, ventilators, oxygen, monitors, pressure mattresses, lifts, nebulizers, hospital beds, bili blankets and bili lights. etc.

Medisys Data Solutions brings years of DME coding and billing experience to you. Your DME services needs the skills and experience to handle complex rentals, sales, rental to sales conversion procedures. We at Medisys Data Solutions are recognized in DME coding and billing.

Below are a few steps from DME billing professionals:

  • Proving medical necessity: A certificate of medical necessity from the physician with the physicians signature and filling of appropriate medical necessity forms can fast track DME rentals reimbursement
  • Capped Rentals: Medicare covers initially for rental, rather than for purchase, often because of its high cost. Medicare pays the rental fees for these items in monthly installments. The patient can keep a capped rental item as long as it is medically necessary and elect to buy it. Reimbursement of capped rentals can be tricky as insurances reimburse them as rentals rather than as purchases.
  • Quality checks and audits: Regular quality checks and frequent audits of coding is a must to avoid repetition of errors. There needs to be open communication between physicians, coders, billers. Physicians need to be educated by coders and billers frequently used ICD and CPT codes by the practice and denials/rejections.
  • Follow ups: Consistent follow ups with the physicians office for incomplete prescriptions reduces the delay in submitting the claims to DMERC (Durable Medical Equipment Regional Carrier).
  • CPAP, BiPAP billing: Suppliers for DME should be careful while billing CPAP (Continuous Positive Airway Pressure), BiPAP (Bilevel Positive Airway Pressure) machines. When billing for durable medical equipment (DME), the use of appropriate HCPCS code and modifier(s) to describe the items being billed, enables quick reimbursements.
  • Use of modifiers: In addition to an appropriate HCPCS code for the DME item, many HCPCS codes require a modifier. The modifiers are used to provide more information about the rental item. The modifier tells that an item is new, used, or rented on a capped basis. For capped rentals, modifiers distinguish which month rental is being billed. If these modifiers are used incorrectly or missing, the claim may be denied.