Documentation Compliance:  Use of Rubber Stamps for Signature For medical review purposes, the Centers for Medicare & Medicaid Services (CMS) requires that services ordered/provided be...

PFA Announces New Members-Only Insurance Benefits The Pedorthic Footcare Association, in partnership with Association Health Programs, is pleased to offer PFA members a new and...

Reminder Regarding the Assignment Agreement When you accept assignment on a claim, you are agreeing to accept the DME MAC's determination of the approved amount...

Medavie Blue Cross to Recognize ABC Certified Pedorthists (C. Peds.) Following a cooperative educational effort by the Pedorthic Footcare Association (PFA) and the American Board for Certification...

Temporary Delay in Implementing Ordering and Referring Denial Edits Due to technical issues, implementation of the Phase 2 ordering and referring denial edits is being...

Medicare Fee-For-Service (FFS) Claims Processing Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10) For dates of service on and after October 1, 2013,...

Sequestration Q & A Do you have questions about how the federal sequestration, resulting in cuts of $85 billion across the board through September 30,...

Full Implementation of the Ordering/Referring Physician Requirement Begins May 1, 2013 As communicated in MLN Matters Article SE1305, DME MAC claim edits to deny invalid...

Mandatory Payment Reductions in the Medicare Fee-for-Service (FFS) Program – "Sequestration" and its Impact on Pedorthists The Budget Control Act of 2011 requires, among other...

Ankle-Foot Orthoses/Knee-Ankle-Foot Orthoses LCD related Policy Article - Revised The related Policy Article for the Ankle-Foot Orthosis/Knee-Ankle-Foot Orthosis is being revised. The Policy Article with...

Medically Unlikely Edits (MUEs) and Clinically Unbelievable Edits (CUEs) Cigna Government Services (CGS) has reported receiving an increase in the number of inquires about Medically Unlikely...

Fifth Quarter Results of Widespread Prepayment Review of Claims for Therapeutic Shoes (HCPCS A5500) Current Review Results The Jurisdiction D DME MAC Medical Review Department...

December 18, 2012, DME CERT Task Force Presentation Available The presentation from the December 18, 2012, DME CERT Task Force webinar on documentation requirements is...

Calendar Year (CY) 2013 Update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule The Centers for Medicare & Medicaid Services (CMS) issued...

Medicare Updates AFO-KAFO Medical Policies The Centers for Medicare and Medicaid Services (CMS) has updated definitions for certain AFO HCPCS Codes.  Click here to read...

HHS OIG Find That Improvements are Needed at the Administrative Law Judge Level of Medicare Appeals The U.S. Dept. of Health & Human Services' Office...

Obama administration moves forward to implement health care law, ban discrimination against people with pre-existing conditions The Obama administration moved forward on November 20 th...

Narrative Required for Not Otherwise Classified HCPCS Codes Suppliers are asked to include a concise description when billing Not Otherwise Classified (NOC) HCPCS Codes.  Click...

4th Quarter Edit Effectiveness for Therapeutic Shoes Review The Jurisdiction D DME MAC Medical Review Department is conducting a widespread complex review of HCPCS codes...

Claim Modifier Did Not Prevent Medicare from Paying Millions in Unallowable Claims for Selected Durable Medical Equipment Click here for the complete story.

2013 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update Now Available Click here to...

DMEPOS Suppliers Must Use Individual Practition​er NPIs to Bill for Ordered/Re​ferred Services   Durable Medical Equipment Medicare Administrative Contractors (DME MACS) will be contacting Durable...

Pennsylvania Becomes Eleventh State to Enact Pedorthic Licensure Requirements to Enhance the Quality of Patient Care in the Commonwealth The Pennsylvania Orthotic and Prosthetic Society...

Notification of Prepayment Review for Orthotic and Prosthetic HCPCS codes NAS Jurisdiction D DME MAC Medical Review will be initiating a widespread prepayment probe review...

UPDATE:  PDAC Coding Verification for the L1940, L1960 and L1970 Click here for the latest.

3 rd Quarter Edit Effectiveness for Therapeutic Shoes Review The Jurisdiction D DME MAC Medical Review Department is conducting a widespread complex review of HCPCS...

Toe Fillers and Diabetic Shoe Inserts - Coding Clarification Questions have arisen about the correct coding for shoe inserts used to accommodate missing digits (toes)...

Coding Verification Reviews for Custom Fabricated Ankle-Foot Orthoses Recently the Durable Medical Equipment Medicare Administrative Contractors (DME MACs), in conjunction with the Pricing, Data Analysis...

HCPCS Codes A5500, A5512 and A5513 – Service-Specific Pre-pay Review in the Jurisdiction C DME MAC CGS, the Jurisdiction C DME MAC, will be implementing...

LCD and Policy Article Revisions Summary for May 2012 Outlined in the article are the significant principal changes to DMEMAC Local Coverage Determinations (LCDs) and Policy Articles...

Iowa Becomes Latest State to Mandate Licensure for Pedorthists, Orthotists and Prosthetists Click here for more information

CMS Announces Final Rule To Prevent Fraud in Medicare and Save Taxpayers Nearly $1.6 Billion Over 10 Years Law Requires Stronger Standards for Ordering and Certifying...

Medicare Quarterly Provider Compliance Newsletter Released The "Medicare Quarterly Provider Compliance Newsletter [Volume 2, Issue 3]” has been released and is now available in downloadable...

Coding Verification Now Mandatory for the L1906 Effective for claims with dates of service on or after April 1, 2012, the only products which may...

Product Labeling Requirements Rescinded – Effective Immediately PDAC has rescinded the requirements for product labeling as outlined in the article titled Product Labeling and Product...