The Centers for Medicare & Medicaid Services (CMS) added 76 new items and deleted three from its master list of durable medical equipment (DME), prosthetics, orthotics, and supplies. CMS may require physicians to submit prior authorizations or written orders and undergo a face-to-face encounter with a patient to assess their condition prior to such equipment’s delivery.
Here’s the master list of durable medical equipment (DME), prosthetics, orthotics and supplies “potentially subject to conditions of payment”: TABLE 13: MASTER LIST OF DMEPOS ITEMS POTENTIALLY SUBJECT TOFACE-TO[1]FACE ENCOUNTER AND WRITTEN ORDER PRIOR TO DELIVERY AND/OR PRIOR AUTHORIZATION REQUIREMENTS.
These items are among those on the list in Table 13 (along with many ostomy supplies and hospital beds):
- A5121 Skin barrier; solid, 6 x 6 or equivalent, each
- A6021 Collagen dressing, sterile, size 16 sq. in. or less
- A6023 Collagen dressing, sterile, size more than 48 sq. in
- A6203 Composite dressing, sterile, pad size 16 square inch or less, with any size adhesive border, each dressing
- A6219 Gauze, non-impregnated, sterile, pad size 16 square inch or less, with any size adhesive border, each dressing
- A6238 Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in.
- A6242 Hydrogel dressing, wound cover, sterile, pad size 16 square inch or less, without adhesive border, each dressing
- A6251 Specialty absorptive dressing, wound cover, sterile, pad size 16 square inch, or less, without adhesive border, each dressing
- A6266 Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard
Here’s an MLN Matters article “Standard Elements for DMEPOS Order, and Master List of DMEPOS Items Potentially Subject to a Face-to-Face Encounter and Written Orders Prior to Delivery and, or Prior Authorization Requirements”.
