DME codes PLEASE HELP

ehughes

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I work for a urologist and I am somewhat new to coding. I believe I am getting confused with what I have been trying to find out about billing DME codes with certain Px. I know to bill DME but some of what I am reading is stating that the Procedure code has the DME included. Please help explain. If anyone is willing to be a mentor to me that would be great. examples are 52000 and A4358,A4351
 

CodingKing

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A codes are not DME; they fall under medical/surgical supplies. If these are supplies used when performing the procedure or dispensed incident to a physician service, they are not separately reportable. It would be the equivalent of billing separately for gauze, scalpel, bandaids Etc The codes have an RBRVS status indicator of P.

P = Bundled/Excluded Codes. There are no RVUs and no payment amounts for these services. No separate payment should be made for them under the fee schedule. --If the item or service is covered as incident to a physician service and is provided on the same day as a physician service, payment for it is bundled into the payment for the physician service to which it is incident. (An example is an elastic bandage furnished by a physician incident to physician service.) --If the item or service is covered as other than incident to a physician service, it is excluded from the fee schedule (i.e., colostomy supplies) and should be paid under the other payment provision of the Act.
 

andijo

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These confuse me as well because if you look at the DME indicator list it states:

**A4310 - A4358
--Incontinence Supplies/Urinary Supplies
--If provided in the physician's office for a temporary condition, the item is incident to the physician's service & billed to the LocalCarrier. If provided in the physician's office or other place of service for a permanent condition, the item is a prosthetic device & billed to the DME MAC.

Which to me sounds in different situations we can bill this to DME, correct?
 
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