Medicare covers DME by Part B Medical Insurance. Lots of federally required records should be submitted with the claims to get it accepted in one go. Medical billing for DME can be quite challenging.
Here is a checklist to peep in and ensure all documents needed are sent flawlessly. This helps in getting payments faster and prevents denials and part payments.
Dispensing Order:
A dispensing order document must be sent with the claim. It should contain the following:
- Name and description of the item
- Name of the physician and beneficiary
- Date of the order
- Sign of the physician.
This is a required document, provided the physician signature on CMN is after the DOS.
CMN order:
It is a bit more informational than the Dispensing Order. It contains all the details of the dispensing order.
Additionally, the below-mentioned details too are present.
- The patient ID
- HCPC codes
- Place of service, supplier and physician information
- Length of the need
- Diagnosis code
- Physician signature and date.
Blood Gas Study Report:
This report can be a part of the progress note or included in the physician’s office visit.
It must contain
- Name of the beneficiary
- The physician who conducted the test.
- Date of test
- Mean of test
- Saturation level in the blood
The date of the test should match the date in the CMN.
The physician’s office visit report should be present, and it should have happened within 30 days of the date mentioned in the CMN.
Delivery Documents:
This document has more info compared with the other documents listed here. It is a vital document, for only this confirms the DME has been sent to the right patient.
As in most cases, the patients are not in a condition to acknowledge the same, and the acknowledgment is done through others.
- Quantity of the supplies
- Name of the beneficiary
- The item’s detailed description
- Details of the manufacturer
- The serial number of the concentrator
- Signature of the person accepting the delivery
- Relationship to the beneficiary and the signature with date.
- The complete address where the equipment is delivered.
This is a detailed checklist that reminds you to fill in every necessary detail to ensure the claim gets accepted at the first submission. The supporting documents are to be sent with the claim and should contain all the pointers mentioned.
In case, you are a doctor and you wish to bill DME for your patient, then you need to submit a different claim. Never include it in the inpatient claim.
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