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

Monday, May 21, 2012   (0 Comments)
Posted by: Brian Lagana
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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 service-specific Medical Review edits for Healthcare Common Procedure Coding System (HCPCS) codes A5500 (FOR DIABETICS ONLY, FITTING [INCLUDING FOLLOW-UP], CUSTOM PREPARATION AND SUPPLY OF OFF-THE-SHELF DEPTH-INLAY SHOE MANUFACTURED TO ACCOMMODATE MULTI-DENSITY INSERT[S]), A5512 (FOR DIABETICS ONLY, MULTIPLE DENSITY INSERT, DIRECT FORMED, MOLDED TO FOOT) and A5513 (FOR DIABETICS ONLY, MULTIPLE DENSITY INSERT, CUSTOM MOLDED FROM MODEL OF PATIENT'S FOOT). These edits are the result of data demonstrating a high claims payment error rate for this product category.  Click here to read the complete story.

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