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CGS Administrators, LLC

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August 27, 2019 - Revised: 09.04.19

Billing Update: Changes to Loaner Equipment and Repairs Modifiers – K0462

Medicare will pay for a temporary replacement of a DMEPOS item while it is being repaired. In these situations, the DME supplier provides a "loaner" piece of equipment to the beneficiary.

The supplier should then bill HCPCS code K0462 (Temporary Replacement For Patient Owned Equipment Being Repaired, Any Type).

Starting October 1st, the DME MACs will begin to deny Loaner Equipment code K0462 for missing information if it does not include the following in the Narrative Section of the claim:

If you receive a denial, we suggest you check for messaging through the CGS Wizard or myCGS to receive additional information on what is needed when you resubmit your claim.

Here is how the narrative might look on a claim for a temporary PAP device out for repair:

"Blower broken on PAP, Pur-06/15, loaner-ResMed S8 Elite II. PBO."

Please visit our abbreviations page to find the proper abbreviations to use in the notes section to be able to fit all the necessary information.

*Please keep in mind that there is no fee schedule for this code (K0462) as payment is determined as the equivalent of one month’s rental for the type of equipment owned by the beneficiary.

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