CMS Relaxes Documentation Requirements for DME Repair Claims
Acceptable Electronic Signatures
For electronically signed documents, such as medical records, Medicare requires that services provided/ordered be authenticated by the author. The following is a list of acceptable electronic signature verbiage that indicates the document has been electronically signed.
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CMS recently issued Change Request 8843 that provides additional guidance to the DME MACs when conducting medical review of DMEPOS repair claims.
Due to the changing environment occurring in the DMEPOS industry and the difficulties Medicare beneficiaries are having in locating suppliers to repair equipment when the original supplier's documentation for the equipment is not available, CMS is providing guidance as to what documentation is required when conducting medical review of DMEPOS repair claims. If Medicare paid for the base equipment initially, medical necessity for the base equipment has been established. Therefore, contractors are to only review the necessity of the repair and make a payment determination. The contractor shall ensure that the supplier's documentation records support the need to restore the equipment to functionality to meet the beneficiary's medical need. This guidance for repairs is to be applied to all DMEPOS equipment owned by Medicare beneficiaries effective for dates of service on and after November 4, 2014.
CMS Instructions to the DME MAC contractor:
CMS Instructions to Audit Contractors (CERT, PSC, RA, ZPICs)
To read the change to the Medicare Program Integrity Manual, Chapter 5, Section .8.1 - Suppliers Documentation for DMEPOS Repair Claims click here.
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