Specializing in Products for Lymphatic/

Vascular Disorders, and Soft Tissue Injuries

Management and Treatment Program for Lymphedema

Accredited by the Joint Commission On

Accreditation of Healthcare Organizations

1.800.876.3563

559 High Street, Suite #1
Pottstown, PA 19464
Fax:1.800.908.3554

After exam occurs

the physician must provide the medical record documentation to the DME supplier, as well as the written order and any supporting documentation

 

CMS may request this documentation up to 7 years.

 

Medicare requires that 5 elements be met for a DME order to be considered valid:

1. Date of the order

2. Beneficiary name ( As it appears on
      their Medicare Card. )

3. Item of DME ordered

4. The prescribing physician’s NPI
      (national provider identifier)

6. Signature of prescribing practitioner
      ( Sorry, RN, PA, PT signatures are
       not valid)

 

Rubber stamped signatures, nor Electronic signatures will be accepted by CMS.
Only original Signatures.

 

Physicians

 

Durable Medical Equipment

Durable Medical Equipment is available for
your patients, but a number new issues
have been introduced by CMS, and Other
insurance companies. In the last few years,
CMS has introduced the “Face to Face “
Rule. The exam must occur within 6
months prior to prescribing the DME
item(s) Exam occurrence must be
documented in the patient’s medical record.

The exam must include and document:

• Evaluation of beneficiary

• Needs assessment

•  Treatment ( All previous treatments need to be listed.)

• Relevant Diagnoses ( What is the Lymphedema due to )

• Medical record must support medical need for DME ordered ( Medicare is
     demanding clinical notes, not letters of medical necessity. )

 

The signed DME item order is not sufficient.

 

For more information contact us at:

Phone:1.800.876.3563

Fax: 1.800.908.3554

Email: ZStimMan@aol.com

 

New ICD-10 codes going into effect as of 10/1/05

 

457.1 converts to I89.0 – Lymphedema, not elsewhere classified.

457.0 converts to I97.2 – Post mastectomy lymphedema syndrome.

757.0 converts to Q82.0 – Hereditary lymphedema

459.81 converts to I87.2 – Venous Insufficiency (chronic) (peripheral)

459.31 converts to I87.319 – Chronic venous hypertension (idiopathic) with ulcer of unspecified lower extremity.

707.12457.1 converts to I89.0 – Lymphedema, not elsewhere classified.

 

454.0 converts to the following:

I83.009 – Varicose veins of unspecified lower extremity with ulcer of unspecified area.

I83.019 – Varicose veins of right lower extremity with ulcer of unspecified site.

I83.029 – Varicose veins of left lower extremity with ulcer of unspecified site.

 

707.10 converts to L97.909 – Non-pressure ulcer of unspecified part of unspecified lower unspecified severity.

707.11 converts to L97.109 – Non-pressure chronic ulcer of unspecified thigh with unspecified  severity.

707.12 converts to L97.209 – Non-pressure ulcer of unspecified calf with unspecified severity.

707.13 converts to L97.309 – Non-pressure chronic ulcer of unspecified ankle with unspecified   severity.

707.14 converts to L97.409 – Non-pressure chronic ulcer of unspecified heel and mid-foot with  unspecified severity.

707.15 converts to L97.509 – Non-pressure chronic ulcer of other part of unspecified foot with  unspecified severity.

707.19 converts to L97.809 – Non-pressure chronic ulcer of other part of unspecified lower leg  with unspecified severity.

 

These new codes must be used on all CMNs, and they must match the codes that
you use in your Clinical notes, and records. There will be hangups, and screw ups during the transition. We ask for your understanding during the changeover.

 

559 High Street  l  Suite #1  l  Pottstown, PA 19464  l  Office:1.800.876.3563  l  Fax:1.800.908.3554

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