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Wiki How to bill out on CMS 1500 DME?

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sempson

sempson

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Soldotna, AK
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Hello,
How do you bill out on the CMS 1500 a knee brace? I entered L1820 and the Medicare EOB stated "you must send the claim to the correct payer/contractor. Claim not payable under jurisdiction area." I called Medicare and they will not help me with this denial. They said to call the Medicare DME line 877-320-0390 yet, this automated line will not take our NPI. We cannot move forward. The EOB states to go to CMS.gov. I can not find any help how to bill this DME. I also looked online and found no help. Does anyone know how to bill this knee brace correctly? Thank you for your help.
 
sempson said:
Hello,
How do you bill out on the CMS 1500 a knee brace? I entered L1820 and the Medicare EOB stated "you must send the claim to the correct payer/contractor. Claim not payable under jurisdiction area." I called Medicare and they will not help me with this denial. They said to call the Medicare DME line 877-320-0390 yet, this automated line will not take our NPI. We cannot move forward. The EOB states to go to CMS.gov. I can not find any help how to bill this DME. I also looked online and found no help. Does anyone know how to bill this knee brace correctly? Thank you for your help.
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There are 4 DME Jurisdictions for Medicare - these can be different from your regular MAC. (For example, Michigan's MAC is WPS, but Michigan's DME contractor is CGS.)

If you're in Alaska, it looks like you're in DME Jurisdiction D. Here's the webpage for Noridian DME - there should be some helpful billing information on this site. I see a whole subsection on billing and claims submission:


(I can't really offer specifics, because I don't typically bill DME and I also don't bill to Noridian. Hopefully you can find what you need on the DME Jurisdiction D site though. Good luck!)
 
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