tci Medicare Compliance & Reimbursement - 2003 Issue 41

MANUAL UPDATE ROUNDUP

A common working file edit flagging too many immunosuppressive drug claims should soon get fixed by the durable medical equipment regional carriers. In an Oct. 17 one-time notification, the Centers for Medicare & Medicaid Services points out that an edit designed to weed out duplicate immunosuppressive drug claims isn't working properly. The problem: The edit sends out an alert whenever immunosuppressive drug claims are submitted along with other, non-immunosuppressive drug DME items on the same date of service by the same supplier (Change Request 2910; http://oig.hhs.gov/fraud/advisoryopinions/aofaq.html). The agency mandates that the edit be fixed by April...

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