Wiki DME Delivered at ASC/Outpatient Facility

kle0204

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Hello!

The CMS LCD pertaining to DME: Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426) only mentions delivery at an inpatient facility. Does anyone know how to bill a DME that was delivered to an ambulatory surgical center/outpatient facility?

We dispense the DME so usually when the patient comes in to pick up their DME, it gets billed under our clinic. In this specific case, the DME was delivered to the ASC on his surgery DOS so the item was given to the patient's spouse, educated on the care and usage of the DME, and she had signed for it.

Since the item was ours/we are the dispensing location, can I bill it out under our clinic on the DOS it was given to the patient's spouse? Are there any specific modifiers or rules I need to look out for?

Thank you so much for your help!
 
Hello!

The CMS LCD pertaining to DME: Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426) only mentions delivery at an inpatient facility. Does anyone know how to bill a DME that was delivered to an ambulatory surgical center/outpatient facility?

We dispense the DME so usually when the patient comes in to pick up their DME, it gets billed under our clinic. In this specific case, the DME was delivered to the ASC on his surgery DOS so the item was given to the patient's spouse, educated on the care and usage of the DME, and she had signed for it.

Since the item was ours/we are the dispensing location, can I bill it out under our clinic on the DOS it was given to the patient's spouse? Are there any specific modifiers or rules I need to look out for?

Thank you so much for your help!
Did you ever receive any guidance on this? I'm sure that contract verbiage plays a role in this, but wanted to check! Thank you!
 
Unfortunately, we didn't get any guidance on this and since we couldn't find anything in the LCDs, NCDs, or anywhere else we could think of, we ended up billing under our clinic because the product was ours and came from our clinic and not ASC.

If you get guidance on this or find anything on your end, please let me know! haha
 
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