License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

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POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

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February 9, 2023

Billing Reminder on Narratives and Date Spanning Claim Dates

Most DMEPOS accessory/supply items provided on a recurring basis can be dispensed with a 3- month supply. These include, but are not limited to, positive airway pressure (PAP) or respiratory assist device (RAD) accessories, nebulizer inhalation medication, and urological supplies.

When billing more than 1 month's supply of these items, include a narrative in the NTE segment of the electronic claim indicating the number of months you are billing. If you bill a 3-month supply of PAP accessories (such as mask, tubing, or cushions), simply add "90 days" or "3 months". This information helps us properly verify the quantities billed.

There are a few exceptions to the 3-month maximum rule. Only a 1-month quantity of supplies may be dispensed for the following:

Surgical dressings
Enteral and parenteral nutrients and supplies
Immunosuppressive drugs
Oral anticancer drugs
Oral antiemetic drugs
Intravenous immune globulin (IVIG)
Ostomy supplies provided in a nursing facility

The supply allowance for therapeutic continuous glucose monitors (CGMs) can only be billed for 1 month of the supply allowance at a time, and no more than 1 unit of service of CGM supply allowance is billable per 30 days.

The following DMEPOS items require a date span on all claims submitted to the DME MACs:

Diabetic testing supplies (such as test strips, lancets; does not apply to CGM supply allowance)
Continuous passive motion devices (CPM)
Parenteral and enteral nutrition
Parenteral and enteral administration kits
External infusion pump supplies (recommended)

Remember to span the dates of service using "From" and "To" dates on any electronic or paper claim for the items listed above.

The "From" date is when the items were provided to the Medicare beneficiary.
The "To" date is the last date the supplies are expected to be used.

Remember this information to make your DME claim process easier and more efficient for everyone.

Originally published May 30, 2019. Revised February 8, 2023.

License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

AMA Disclaimer of Warranties and Liabilities.

CMS Disclaimer

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

Billing Reminder on Narratives and Date Spanning Claim Dates

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