For DME billing, ICD-10 diagnosis codes are also used, indicating the medical condition of the patient for which the equipment was prescribed. DME or durable medical equipment billing requires appropriate HCPCS (Healthcare Common Procedure Coding System) codes and modifiers. These are needed for describing the items that are being billed.

1. For DME billing, ICD-10 diagnosis codes are also used, indicating
the medical condition of the patient for which the equipment was
prescribed. DME or durable medical equipment billing requires
appropriate HCPCS (Healthcare Common Procedure Coding
System) codes and modifiers. These are needed for describing
the items that are being billed.
When a lab requisition, request or referral for DME is being filled,
coders will need ICD-10 codes for a patient’s diagnoses.
In DME billing, coders need accurate HCPCS codes along with
modifiers that are used for providing more information about the
equipment. If the coders are failing to use modifiers or using them
in an incorrect manner, then the claims may get denied. Some of
the common modifiers include RR- rental, UE- purchase of used
equipment and NU- purchase of new equipment.
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2. Intricacies of DME coding:
• DME coding intricacies can be quite challenging for coders.
This is because DME codes are deeply rooted in HCPCS
Level II codes and policies by Medicare. If the codes are not
being assigned in the right manner, claims will get denied.
• When a coder uses HCPCS Level II code ending in 99, it is
important to provide supporting documentation for billing that
code.
• DMEPOS or durable medical equipment, prosthetics, orthotics
and supplies are classified as HCPCS Level II codes that start
with a letter and are followed by numbers. Whenever a coder
is using HCPCS Level II codes, he/she needs to ensure that
they are covered by Medicare.
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3. Here are the new modifiers:
• Modifiers CO and CQ
• Modifier ER
• Modifier G0
• Modifier QA, QB and QR
• Modifier QQ
• Modifier VM
There have been certain 2019 changes to the Level II HCPCS
codes as well, applicable to items that come under Medicare
DME MAC jurisdiction.
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4. About 247 Medical Billing Services:
We are a medical billing company that offers ‘24/7 Medical Billing
Services’ and support physicians, hospitals, medical institutions
and group practices with our end to end medical billing solutions.
We help you earn more revenue with our quick and affordable
services. Our customized Revenue Cycle Management (RCM)
solutions allow physicians to attract additional revenue and reduce
administrative burden or losses.
Contact:
247 Medical Billing Services
Tel: +1 888-502-0537
Email: info@247medicalbillingservices.com
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