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Issue Number - Name
0112-DME while in Hospice
Review Type
Automated
Claim Type
DME by Physician, DME by Supplier
Region and State
RAC 5
All States
Date Approved
09/11/2018

Description

All DME billed after the admit date of a beneficiary to hospice services and before the discharge date of a beneficiary from hospice services, will be denied as inclusive to hospice services unless there is a GW modifier present indicating DME is not related to the hospice diagnosis.

Affected Code(s)

Applicable Policy References

42 Code of Federal Regulations, Section 418.202 (f) 
CMS Pub. 100-2, Medicare Benefit Policy Manual, Chapter 9, Section 10
CMS Pub. 100-4, Medicare Claims Processing Manual, Chapter 11, Sections 10, 30.3, 40.2
CMS Pub. 100-4, Medicare Claims Processing Manual, Chapter 20, Section 10.2

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