July DMEPOS Update Includes Retroactive Changes

The Centers for Medicare & Medicaid Services’ (CMS’) July Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) update includes changes retroactive to Jan. 1, 2012.

HCPCS Level II codes L6715 Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement and L6880 Electric hand, switch or myolelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s) are added to the HCPCS file effective Jan. 1, 2012. The fee schedule amounts for these codes are effective for claims with dates of service on or after Jan. 1, 2012. CMS says these items were paid on a local fee schedule basis prior to implementation of the fee schedule amounts established in accordance with this update.

Already processed claims for codes L6715 and L6880 with dates of service on or after Jan. 1, 2012 may be adjusted to reflect the newly established fees if you bring those claims to your contractor’s attention.

Per Change Request (CR) 7679, the claims filling jurisdiction for the following HCPCS Level II codes is changed from DME MAC to joint local carrier and DME MAC jurisdiction, effective Jan. 1, 2012:

L8511 Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only

L8512 Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10

L8513 Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each

L8514 Tracheoesophageal puncture dilator, replacement only, each

L8515 Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each

Source: CMS Transmittal 2467, CR7822, issued May 11

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