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Reprocessing of Claims for Certain Replacement Parts, Accessories, or Supplies for Prosthetic Implants and Surgically Implanted Durable Medical Equipment (DME) with Dates of Service of October 27th, 2008 through December 31, 2009

CMS issued Change Request (CR) 6573, Transmittal 531 on August 14, 2009. This CR included a list of HCPCS codes that could be billed as a replacement part, accessory, or supply for prosthetic implants and surgically implanted DME according to guidelines established by CR 5917. However, CR 6573 did not include instructions to process these HCPCS codes under the guidelines of CR 5917 until January 1, 2010. This CR instructs the contractors to reprocess claims with dates of service October 27, 2008 through December 31, 2009 containing the HCPCS codes found in the Attachment to CRs 6573 and 6914, using the guidelines established by CRs 5917 and 6573.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: June 11, 2010

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.