This electronic resource provides 11 very useful, detailed examples of typical DME MAC/DMERC claims that would be billed for denial. Coding requirements and expected denial code results from the DME MAC/DMERC are also included.
Examples are provided for:
- Infusion drug therapy via gravity.
- Infusion drug therapy via DME pump for non-covered drug
- Total Parenteral Nutrition and Enteral therapies (5 examples) IVIG infusion (4 examples with different coverage scenarios)
- IVIG Infusion Therapy (4 examples with different coverage scenarios)
Other content includes general guidance from NHIA and instructions from the Centers for Medicare & Medicaid Services and the DME MAC/DMERCs.
In addition, NHIA will provide regular updates to the booklet via a web link as they are made available.
Click here to view the introduction to this reference tool.
Corporate and corporate provider members are eligible for volume discounts — contact the NHIA office for details.
The product is provided electronically in Adobe® pdf file format. Your purchase provides you with the right to use multiple copies within a single location, from where you may also include content from template letters found in the tool with your submissions of claims to secondary health plans.
For use in multiple locations — contact the NHIA office at 703-549-3740 for volume discounts.
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