Suppliers Receive Payment for Separately Billable Repairs

For the past six months, suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) may have been unwittingly shortchanging their reimbursement. HCPCS Level II codes for separately billable DMEPOS repairs were not included in previous guidance released last year by the Centers for Medicare & Medicaid Services (CMS), which went into effect Jan. 1.

Change Request (CR) 6914 amends attachment A of CR 6573 with the following list of HCPCS Level II repair codes that may be billed separately under the billing guidelines established in CRs 6573 and 5917.

Code                Description

K0739                Repair or non-routine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes

L7500               Repair of prosthetic device, hourly rate

L7510                Repair of prosthetic device, repair or replace minor parts

L7520                Repair prosthetic device, labor component, per 15 minutes

L8627                Cochlear implant, external speech processor, component, replacement

L8628                Cochlear implant, external controller component, replacement

L8629                Transmitting coil and cable, integrated, for use with cochlear implant device

Q0506                Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only

Effective Jan. 1 through Oct. 4, DMEPOS suppliers may bill separately for any of the repair codes included in this list in addition to the codes for replacement parts, accessories, and supplies for prosthetic implants and surgically implanted DME previously communicated in attachment A of CR 6573. Contractors will continue to process claims for these codes according to the guidelines established by CRs 5917 and CR 6573.

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