Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
Corrected Contact Numbers
The contact numbers for DMEPOS Prior Authorization in the July Claim
Jumper were incorrect. The correct numbers are:
Fax: Toll-free local and long distance 1-877-443-2580
Phone: Local (406) 457-5887
Phone: Toll-free long distance 1-877-443-4021, ext. 5887
Provider Manuals (Updated March 5, 2008)
Medicaid Rules/Regulations (Updated May 9, 2006)
Fee Schedules (Updated January 15, 2008)
Notices and Replacement Pages (Updated June 17,
2008)
DMEPOS Workgroup (Updated December 21, 2004)
Other DMEPOS Resources (Updated January 2, 2008)
Remittance Advice Notice
Key Contacts (Updated March 1, 2007)
Provider
Manuals
General Information
For Providers
Medicaid billing manual with general information for all provider types.
04/2005
Durable Medical Equipment,
Prosthetics, Orthotics, and Medical Supplies (DMEPOS)
This manual has billing instructions specific to your provider type.
03/2008
Competing the HCFA-1500
Form
Instructions for completing a CMS-1500 claim form (formerly HCFA-1500).
08/1998
Medicaid
Rules/Regulations
Administrative
Rules of Montana (ARM)
Montana
Code Annotated (MCA)
Code
of Federal Regulations (CFR)
Fee
Schedules
Current Fee Schedule
in PDF Format
01/2008
Current Fee Schedule
in Excel Format
01/2008
Previous Fee Schedule
in PDF Format
07/2007
Previous Fee Schedule
in Excel Format
07/2007
Previous Fee Schedule
in PDF Format
01/2007
Previous Fee Schedule
in Excel Format
01/2007
Previous Fee
Schedule in PDF Format
11/2006
Previous Fee Schedule
in Excel Format
11/2006
Previous Fee Schedule
in PDF Format
07/2006 (Updated 10/2006)
Previous Fee Schedule
in Excel Format
07/2006 (Updated
10/2006)
Previous Fee Schedule
in PDF Format
01/2006
Previous Fee Schedule
in Excel Format
01/2006
Previous Fee Schedule
in PDF Format
01/2005 (Updated 12/2005)
Previous Fee Schedule
in Excel Format
01/2005 (Updated 12/2005)
Previous Fee Schedule
in PDF Format
01/2004
Previous Fee Schedule
in Excel Format
01/2004
Previous Fee Schedule
in PDF Format
07/2003
Previous Fee Schedule
in Excel Format
07/2003
Previous Fee Schedule
in PDF Format
02/2003
Previous Fee Schedule
in Excel Format
02/2003
Previous Fee Schedule
in PDF Format
07/2002
Previous Fee Schedule
in Excel Format
07/2002
Previous Fee Schedule
in PDF Format
01/2002
Previous Fee Schedule
in Excel Format
01/2002
Notices
and Replacement Pages
06/09/08
Billing and Policy
Changes
05/22/08
Frequently
Asked Questions About NPI Reenrollment and Billing -
Updated June 17!
04/14/08
New Codes for Disposable
and Reusable Incontinence Products
03/25/08
New Rules Effective
January 1, 2008
03/25/08
Durable Medical Equipment
Coverage for Clients With Basic Medicaid Only
03/17/08
Resubmission
of Denied Claims - Updated March 19!
03/10/08
NPI Reenrollment
and Billing
03/05/2008
DMEPOS Manual Replacement
Pages - Covered Services, Submitting a Claim
01/18/08
Possible
Duplicate Claims Processed Through Electronic Data Interchange
12/17/07
Enhanced
Claims Editing—Assistant / Team / Co-Surgeon
12/17/07
Enhanced
Claims Editing—Multiple Evaluation and Management Services Provided
on the Same Day
12/03/07
NPI Requirement
for Fee-for-Service Healthcare Provider Claims
11/27/07
Cost Share
Changes
11/01/07
Enhanced
Claims Editing—Add-on Codes
11/01/07
Enhanced
Claims Editing—New Visit Evaluation and Management Codes
11/01/07
Enhanced
Claims Editing—Bloodhound ClaimsGuard®
08/29/07
Criteria for Gait
Trainers
08/29/07
Criteria for Wheel
Chair Seating in the Nursing Home
08/29/07
Criteria for Group
2 Support Surface
08/01/07
Elimination
of ESOR
06/25/07
NPI on
the Web Portal
06/11/07
Ownership
and Control Information Required for Reenrollment
06/06/07
NPI Contingency
Plan Implemented, Reenrollment Extended
05/31/07
New CMS-1500
to Be Required Beginning July 2, 2007
01/12/07
Medicare Changes
in Certificate of Medical Necessity (CMN)
01/12/07
Revised Fee and Criteria
on Phototherapy (Bilirubin) Light With Photometer
12/22/06
Prior Authorization
for DMEPOS and Medical/Surgical Procedures Updated Phone and Fax Lines
11/08/06
Prior Authorization
on the Move
11/02/2006
Durable Medical Equipment
Coverage for Clients With Basic Medicaid Only
10/10/2006
Separately Billable
Supplies
07/24/2006
Capped Rental
05/17/2006
Durable Medical Equipment
Coverage for Clients With Basic Medicaid Only
05/17/2006
Coverage of Seat
Lift Mechanisms
10/11/05
Wheelchair
CMNs - Transition Instructions
07/28/05
Scales - Congestive
Heart Failure
04/29/05
General Manual
Replacement Page - Member Number a Billable Number and Key Contacts
Updated
04/07/05
DMEPOS Manual
Replacement Pages - Removed CPAP CMN
02/04/05
Introduction to
Preferred Drug List
01/21/05
DMEPOS Manual
Replacement Pages - Apnea Monitor PA Requirements
12/09/04
Diaper/Incontinence
Product Coding Changes
11/05/04
General
Manual Replacement Pages - References to Medicaid Rules/Regulations
Added
09/16/04
General Manual
Replacement Pages - Team Care and Nurse First Information Added
06/10/04
Team Care Program
- A New Component of the Passport to Health Program
01/01/04
January 2004 Fee Schedule
Update
08/29/03
Passport to Health
Implementation in Prairie County
08/29/03
DMEOPS Advisory Workgroup
Openings
08/29/03
DMEOPS Payment Project
08/20/03
Submitting
HIPAA Compliant Claims - Information for All Providers
07/07/03
External Insulin Pump
Requirements
07/02/03
Electric Breast Pump
Requirements
05/22/03
Discontinued Services
05/12/03
Provider Rate
and Payment Update
03/03/03
Coding and Reimbursement
Revisions
03/03/03
Deleted HCPCS Codes
02/28/03
New Modifier
01/10/03
New Provider
Notification Procedure and Medicaid Changes
10/01/02
Billing for Medicare
Crossovers after Medicare's 45 Day Response Time
09/01/02
Cost Sharing
07/01/02
2.6% Reduction
03/21/02
Prior Authorization
Reminders: DME, DMEOPS
02/14/02
Weekly Payment
Available
DMEPOS
Workgroup
DMEPOS
Advisory Workgroup Meeting Minutes
Minutes from DMEPOS Advisory Workgroup meeting July 8, 2004.
DMEPOS
Advisory Workgroup Meeting Minutes
Minutes from DMEPOS Advisory Workgroup meeting April 14, 2004.
Mission
Statement
DMEPOS Advisory Workgroup mission statement.
DMEPOS Advisory
Workgroup Members
List of all members of DMEPOS Advisory Workgroup with address, phone
and E-mail.
Other
DMEPOS Resources
Noridian
Administrative Services
Medicare's DME Administrative Services provider
10/2006
2008
Medicaid Payment Schedule
Medicaid claims payment schedule for 2008
01/2008
Self
Audit Policy and Procedure
06/2007
Carrier ID List
TPL insurance carriers listed by carrier ID
06/2007
Carrier ID
List
TPL insurance carriers listed by name
06/2007
Region
D DMERC/CIGNA Medicare
The Durable Medical Equipment Regional Carriers (DMERCs) web site. DMERC
processes Durable Medical Equipment, Prosthetics, Orthotics and Supplies
(DMEPOS) for Medicare.
Date N/A
The
Statistical Analysis Durable Medical Equipment Regional Carrier (SADMERC)
This web site assists manufacturers and suppliers with DMEPOS billing
and coding information.
Date N/A
EOB
R&R Crosswalk in PDF format
EOB R&R
Crosswalk in Excel format
With the implementation of HIPAA, Medicaid will discontinue the use
of Medicaid EOB codes and begin using HIPAA standard reason and remark
codes (R&R) . This document crosswalks the HIPAA standard R&R
codes to the Medicaid EOB codes.
01/26/04
Remittance
Advice Notice
Your current RA message is as follows:
New 1099 Process
December 14, 2006
Medicaid providers will see a change in the 1099s received for 2006
reporting Medicaid payments. Effective for calendar year 2006 and forward,
ACS will no longer be generating and mailing a separate 1099 for Medicaid
payments. The Department of Administration will be combining all payments
by tax identification number into one 1099 instead of a separate 1099
for each Medicaid provider number. If you have any questions, please
contact Roy Hinman at (406) 444-5932 or Susan Austad (406) 444-4060
at the Department of Public Health and Human Services.
Key
Contacts
DME
08/2002
CHIP
08/2002
Claims
08/2002
County Offices
01/2005
Eligibility
05/2006
Passport
07/2006
Policy Information
07/2006
Prior Authorization
03/2007
