9.25.09 – DCS Healthcare publishes first CMS-approved issues for Region A
DCS Healthcare, the RAC for Region A, has published the first CMS approved issues for audits in the states of Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont.
The three issues, including one new issue not yet approved in other RAC regions, are applicable to durable medical equipment (DME) suppliers in the mentioned states. According to the DCS Web site, the issues include the following:
- Pharmacy supply and dispensing fees. Pharmacy supply and dispensing fees when billed by a DME supplier are required to be accompanied with an oral anti-cancer, oral anti-emetic, immunosuppressive drug or inhalation drug. The absence of one of the aforementioned drugs billed on the same date of service or a denial of one of the aforementioned drugs represents an overpayment.
- Wheelchair bundling. A potential vulnerability may exist if certain procedure codes are billed in conjunction with other procedure codes for the same date of service and the same beneficiary.
- Urological bundling. A potential vulnerability may exist if certain urological procedure codes are billed in conjunction with other urological procedure codes for the same date of service and same beneficiary.
More information on the CMS approved issues for Region A is available in the DCS healthcare webpage.
