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Commercial Reimbursement Policy Updates for November 13, 2023

Reimbursement PolicyRevision
Bundling Guidelines

Wheelchair Bundling renamed to “DME Bundling.” Medical Director Approved.

Pricing and Adjudication Principles

Added bullet 16 for overlapping or duplicative services.  Medical Director approved. 

Supply and Equipment

Policy language added to Supplies and Equipment Billing Requirements.  Added TENS device modifier requirements, therapeutic mold inserts for diabetics, intermittent catheter, reimbursement of portable oxygen and accessories, routinely purchased DME.  Added diabetic shoes and inserts and category “INDME to Non-Reimbursable Supplies and Equipment.  Medical Director approved.