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Medicare Non-Billable Supplies

  1. Default Medicare Non-Billable Supplies
    Medical Coding Books
    I find the online CMS site of very little help when trying to find something specific. Can anyone tell me where I can find a list of Medicare 'non-billable' or 'non-covered' supplies in the IP or OP setting? I'm referring to items such as linens, slippers, etc.

    Dawn Voris, CPC
    Physician's Health Plan of Northern Indiana

  2. #2
    Swainsboro/Statesboro, GA
    Default Routine supplies
    Hey Dawn,

    I don't think you are going to find a list of these items on the CMS website. Back in 2000, the beginning of OPPS, information was given through the FI's about items being considered rountine vs. non-routine. There were a few FI's who actually published partial lists, but not all did this. It was another one of those things left up to each facility!

    At one time, I did have paper copies of what the Georgia FI printed about this issue, but unfortunately that was 8 years ago and I no longer have those documents. But the concepts should still apply, so here is what I remember from that time!

    A supply can be billed if it is specific to that patient, medically necessary and physician ordered. In other wrods, if everyone gets it, or if most patients get it, it would be considered routine and therefore not billable. Also, if it is a reusable item, it would not be billable. It must be a disposable item.

    Convenient items are also nonbillable. These are things like water pitchers, and what use to be called admission kits.

    The facility I worked for at that time made the decision to NOT bill any supply item, even if it met the criteria above, if our cost was under $5. So I used those guidelines or "tests" before adding any item to our chargemaster; that being: specific to the patient, disposable, not everyone receives and cost under $5.

    You may also want to check your FI or MAC website as I found more specific info there vs. the CMS website. You may also want to try searching in bulletins from 2000 and 2001 as that's when most of these regulations were coming into being.

    Good luck!
    Freda Brinson
    Savannah, GA

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