Medicare Contractors to Hold ’11 Home Dialysis Claims
Year 2011 end stage renal disease (ESRD) home dialysis claims for continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) are being held and will not be released for processing until as late as Feb. 21.
Payment for these claims is not being correctly adjusted for the daily rate, resulting in overpayments. The Centers for Medicare & Medicaid Services (CMS) has asked contractors to hold home dialysis claims for CAPD and CCPD with dates of service on or after Jan. 1 to prevent subsequent overpayments and reduce the number of necessary adjustments to claims.
Once claims are released for processing, contractors are required to adjust claims that were paid incorrectly within 30 days.
Hemodialysis claims are not impacted and will not be held.
Source: WPS Medicare