CMS has decided not to proceed with its proposed changes to the existing miscellaneous HCPCS E1399 and K0108. Recently, CMS proposed to divide these two ‘catch all’ codes into six new codes that would impose three pricing/reimbursement categories: (1) Inexpensive DME; (2) Other DME or Expensive DME; and (3) Replacement parts for DME being repaired. CMS was seeking to reign in the use of miscellaneous codes and apply a fee schedule structure to avoid paying in excess for supplies which are always reimbursed as a purchase under the current model.
Comments were sought on the proposed changes and the comment period closed on July 9th. CMS originally indicated that the proposed fee schedule amounts would be applied beginning January 1, 2016; however, that decision to move forward on January 1st has been stalled. CMS issued an update to the original document that reads: “We appreciate the comments received on the proposed coding changes below and will continue to consider the issue further. The changes described below will not take effect on January 1, 2016. Additional information will be provided on the status of these coding changes in the future.”
As of now, suppliers will continue to utilize the existing miscellaneous codes E1399 and K0108 until further notice.
As of now, suppliers will continue to utilize the existing miscellaneous codes E1399 and K0108 until further notice.
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