Medicare DMEPOS Requiring Prior Authorization
7 tips for writing exam essays go nursing school vs working essay //claudiacohenfoundation.org/cialis-mexico/ follow site how long for viagra to work on women source follow url metaphorical essays cialis richtig einnehmen hypertrophie benigne de la prostate et viagra a cover sheet for an essay cheap scholarship essay ghostwriter services for university see url https://abt.edu/bestsellers/se-procurer-du-viagra-sans-ordonnance/22/ muneeb ahmed cialis standard dosage cialis ageing population in singapore essay samples https://mdp.berkeley.edu/wp-content/uploads/?online=can-you-use-our-in-an-essay purposive sampling in qualitative research ethical consideration in research technology sample essay https://www.thehasse.org/does/cialis-5-mg-diario-precio-argentina/45/ dance music production essay prednisone 10mg dose pack directions essay of first impressions cialis accepts paypal article name in essay source site https://www.thehasse.org/does/canadian-levitra-generic/45/ durao cialis 6 paragraph persuasive essay rubric 8th Beginning January 2017, certain DMEPOS items will require prior authorization from the Medicare Administrative Contractor.
Prior authorization is a process through which a request for provisional affirmation of coverage is submitted to a medical review contractor for review before the item or service is furnished to the beneficiary and before the claim is submitted for processing. It is a process that permits the submitter/requester (for example, provider, supplier, beneficiary) to send in medical documentation, in advance of the item or service being rendered, and subsequently billed, in order to verify its eligibility for Medicare claim payment.
For any item or service to be covered by Medicare it must:
- Be eligible for a defined Medicare benefit category
- Be medically reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member
- Meet all other applicable Medicare coverage, coding and payment requirements
The following items require prior authorization:
- K0856: Power wheelchair, group 3 std., single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0861: Power wheelchair, group 3 std., multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
Providers/suppliers should expect the prior authorization regulation to expand in the future for items that are considered frequently subject to unnecessary utilization. For more information visit CMS.Gov.