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Issue Number - Name
0046 - Multiple DME Rentals in One Month
Review Type
Automated
Claim Type
DME by Supplier and DME by Physician
Region and State
RAC 5
All States
Date Approved
2017-03-29

Description

Overpayments associated with DMEPOS suppliers billing multiple rentals for the same equipment within the same month (27 days).

Affected Codes

  • No specific codes

Applicable Policy References

  • Social Security Act, Volume I, Title XVIII, Section 1834, Subsection (2)(B)
  • Social Security Act, Volume I, Title XVIII, Section 1834, Subsection (3)(A)
  • Social Security Act, Volume I, Title XVIII, Section 1834, Subsection (5)(A)
  • Social Security Act, Volume I, Title XVIII, Section 1834, Subsection (7)(A)(i)(1)
  • Social Security Act, Volume I, Title XVIII, Section 1834, Subsection (7)(C)(ii)(1)
  • Code of Federal Regulations, Title 42, Part 405, Subpart I, Subpart Section 405.986
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 20, Section(s) 30.2, 30.5, 30.7 and 130.8 
  • CMS Pub. 100-08, Medicare Program Integrity Manual, Chapter 3, Section 3.5, Subsection 3.5.1 and Section 3.6
  • DMEPOS Fee Schedule, 2014 and forward, select codes from Categories FS (Frequency Serviced Items), CR (Capped Rental), and OX (Oxygen & Oxygen Equipment)