TOS Error Detected in 2011 HCPCS Level II File

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  • May 13, 2011
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The Centers for Medicare & Medicaid Services (CMS) informed contractors on April 29 of several indicator errors in the 2011 type of service (TOS) annual update, as well as in the 2011 HCPCS Level II file. Change Request (CR) 7407 corrects these errors.
According to the CMS transmittal, contractors are using an incorrect TOS for durable medical equipment (DME) code A7020 Interface for cough stimulating device, includes all components, replacement only. The 2011 HCPCS Level II file contains the wrong TOS indicator for this code. The correct TOS for A7020 is A,P,R.
A Used DME
P Lump Sum Purchase of DME, Prosthetics, Orthotics
R Rental of DME
TOS indicators sometimes affect payment, but CMS says it appears all claims are being processed correctly.

See Transmittal 2204, CR 7407, for additional TOS changes, effective Jan. 1.

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