February 16, 2023
How to Bill Correctly for Items Provided During Inpatient Stays
In a report several years ago, the Office of Inspector General (OIG) determined that Medicare improperly paid suppliers for DMEPOS items provided during inpatient stays. Medicare should not pay a supplier for items furnished to a beneficiary when the beneficiary is still an inpatient.
Suppliers should use the Consolidated Billing Tool to identify when an item is separately billable to the DME MACs.
CMS developed the Medicare DMEPOS Improper Inpatient Payments Fact Sheet to help you bill correctly.
Additional resources:
- Medicare Quarterly Provider Compliance Newsletter, Volume 9, Issue 2
- Medicare Claims Processing Manual, Chapter 20, Section 10
- Medicare Claims Processing Manual, Chapter 30, Section 130.1
Originally published August 12, 2019. Revised February 2023.