Commercial Reimbursement Policy Updates for November 13, 2023
| Reimbursement Policy | Revision |
|---|---|
| Bundling Guidelines (PDF) | Wheelchair Bundling renamed to “DME Bundling.” Medical Director Approved. |
| Pricing and Adjudication Principles (PDF) | Added bullet 16 for overlapping or duplicative services. Medical Director approved. |
| Supply and Equipment (PDF) | Policy language added to Supplies and Equipment Billing Requirements. Added TENS device modifier requirements, therapeutic mold inserts for diabetics, intermittent catheter, reimbursement of portable oxygen and accessories, routinely purchased DME. Added diabetic shoes and inserts and category “IN” DME to Non-Reimbursable Supplies and Equipment. Medical Director approved. |
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