Removal of VIPS Medicare System (VMS) and Common Working File (CWF) Edits That Deny Claims for Parenteral or Enteral Services and/or Supplies if a Provider Has Not Recertified the Beneficiary’s Need for Parenteral or Enteral Services and/or Supplies
In January 2007, durable medical equipment program safeguard
contractors (DME PSCs) implemented a local coverage determination (LCD) that removed the requirement
for one routine recertification of a beneficiary’s need for parenteral or enteral services and/or supplies at 6
months after the initial certification of the beneficiary’s need for parenteral or enteral services and/or
supplies. A VMS edit and a CWF edit are in place that continues to deny claims for beneficiaries that have
not received a recertification. These edits continued to deny a large number of claims. To eliminate the
impact of those denials on beneficiaries, DME PSCs implemented a manual process to approve claims that
the VMS edit denied.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 18, 2008
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