Medicare Payment on Deceased Patient

[browninge]

So we had a patient that we had a custom ankle brace made for. Before we could dispense the brace to the patient died. Just wondering if anyone has billed Medicare for this issue before? Everything I am reading tells me to bill the DOS as the date the patient died, but are there any specific modifiers that are needed? I am not finding much info on this. Thanks for the help!!

 

[cmiranda]

Hello

Per the CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 20.3 This link will take you to an external website. If a custom-made item was ordered but not furnished to a beneficiary because the individual died or because the order was canceled by the beneficiary or because the beneficiary's condition changed and the item was no longer reasonable and necessary or appropriate, payment can be made based on the supplier's expenses. In such cases, the expense is considered incurred on the date the beneficiary died or the date the supplier learned of the cancellation or that the item was no longer reasonable and necessary or appropriate for the beneficiary's condition.
This only applies to the specific situation of the beneficiary's death or cancellation and would not be for other circumstances, such as being admitted to a SNF. The above rules would then not apply.

Hope this helps.

Corina