Billing Medicare DME outside of my jurisdiction.

lauriemr1

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Hi all. I have a few Medicare recipients that are snow birds. My DME claims are getting denied because I am in JC and their policies are in JA. Medicare(CGS) told me to bill to that jurisdiction. I have tried to bill the jurisdiction they are in but get denied their as well. Any advice on getting these paid?
 

cassyn86

Networker
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Cleveland, TN
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In the past I have had the same scenario where the patients address puts their DME in a different jurisdiction. In the past I have had the other jurisdiction make payment. What is the denial reason they are giving you?
 

lauriemr1

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The denial is "incorrect carrier". I wonder if I just got the wrong jurisdiction when I rebilled. If you are getting paid then that's probably what happened. Thanks so much!!
 

CLCameron

Contributor
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KT modifier

Hello!

If you don't have a KT modifier appended, if you find out that you are billing the correct MAC and still getting denied, that may be the reason.

If you haven't already read it, you may find this fact sheet from CMS helpful. It explains how to bill DME for traveling beneficiaries.

I hope you get a swift resolution to your claims!
 

lauriemr1

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KT Mod

I did not know about the KT mod. That is most likely the problem. Very helpful. Thank you!
 
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