Establish Pre-Payment Autodenial Edits in Applicable States for DMEPOS Suppliers of Oxygen and Oxygen Equipment (DME MACs only).
Medicare DMEPOS suppliers who submit claims for Medicare payment for oxygen and/or oxygen related equipment must properly enroll with the National Supplier Clearinghouse (NSC). Presently, 38 states require licensure and/or certification to provide oxygen and/or oxygen related equipment. This instruction requires the NSC to assign an oxygen specialty code to all suppliers who have
indicated they will be providing oxygen and/or oxygen related services on their CMS 855S enrollment application and also requires DME MACs to edit claims to look for the oxygen specialty code and submit a quarterly report of oxygen and/or oxygen related equipment DMEPOS supplier false claim submission attempts to CMS. The NSC shall research the reported DMEPOS suppliers using their current procedures outlined in the Scope of Work and/or Pub. 100-04, section 20.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 18, 2008
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