At long last, Medicare is giving physicians who specialize in sleep medicine a little recognition by giving them their own specialty code. The Centers for Medicare & Medicaid Services (CMS) makes new specialty code CØ official in transmittal 2462. The new code is effective April 1, 2012.
Sleep medicine doctors can self-designate their specialty on the Medicare enrollment application (CMS-855I) or Internet-based Provider Enrollment, Chain and Ownership System (PECOS) when they enroll in the Medicare program, or revalidate their enrollment.
Also in this transmittal, CMS establishes sports medicine code 23 for durable medical equipment Medicare administrative contractors (DME MACs) and ViPS Medicare System (VMS). This specialty code has already been established for Part A/B MACs, fiscal intermediaries (FIs), carriers, and regional home health intermediaries (RHHIs) and their respective shared system maintainers in transmittal 2098.
Specialty codes are used by CMS for programmatic and claims processing purposes.
May 11th, 2012
Effective July 1, providers and suppliers appending the technical component (TC) to advanced diagnostic imaging procedures will have a new specialty code to report on claims. Change Request 7175, issued April 12 by the Centers for Medicare & Medicaid Services (CMS), establishes specialty code 95 Advanced Diagnostic Imaging Accreditation.
Providers and suppliers who supply the TC of advanced diagnostic imaging services for Medicare patients must be accredited by Jan. 1, 2012 to be reimbursed by Medicare. This requirement does not apply to the physicians who only interpret the images.
See MLN Matters article MM7177 Revised for more information regarding accreditation requirements.
April 15th, 2011
Effective Jan. 1, 2011, the Centers for Medicare & Medicaid Services (CMS) will establish durable medical equipment prosthesis, orthotics and supplies (DMEPOS) specialty code B5 for ocularists.
The American Society of Ocularists defines an ocularist as a “carefully trained technician skilled in the arts of fitting, shaping, and painting ocular prostheses.” In addition to creating ocular prostheses, the ocularist shows the patient how to handle and care for them, and provides long-term care through periodic examinations.
Patients who need to be referred to an ocularist usually fall into the following categories:
- Recent enucleation/evisceration
- Problems with an existing prosthesis
- Blind eyes requiring a scleral shell
- Congenital anophthalmia/microphthalmia
Patients with existing ocular prostheses often need to be referred to the ocularist for problems with either the surface condition of the prosthesis or problems with the fit of the prosthetic eye or scleral shell.
Services provided by the ocularist include:
- Cleaning
- Polishing
- Enlargement
- Reduction
- Replacement
Due to the requirements of most insurance policies, a written prescription from the referring physician or other appropriate eye care specialist often is required.
August 27th, 2010