Wiki DMERC Denials

[mjlan_72@yahoo.com]

I have ran across a patient's claim where DMERC is denying: Benefit maximum for this time period or occurrence has been reached. We billed out 1 unit of L3670-LT-KX this year. Anybody have any suggestions on how to deal with the denial?

 

[SharonCollachi]

Well, have they received a shoulder orthosis already?

 

[mjlan_72@yahoo.com]

Not from our office.

 

[SharonCollachi]

Not from our office.

Well, it's not per office, it's per patient. Ask the patient.

 

[mjlan_72@yahoo.com]

Well, it's not per office, it's per patient. Ask the patient.

Thank you.