Has anyone experienced recent non-payment of DME “A” codes? Examples include nebulizer tubing and mouthpiece KIT for administering albuterol neb solution A7005 and face-mask A7015 as well as A5112-urine collection. Previously billed with modifier NU or no modifier with proper reimbursement until 2 months ago. I am in Maryland and this appears to be a new trend with medicaid claims. I am unaware of a “new modifier” needed for billing these items. Thanks!
We’ve noticed recent denials as well. Plan on submitting Hassle Factor Forms with AAP.
we were told its bundeled, vt
Melissa thanks! The AAP option has been really SLOW. Please update if you are in receipt of a reply.
Just an update. I was reading the AAP’s Coding for Pediatrics and came across this in reference to HCPCS codes:
so I’m assuming this is why they are no longer paying for the A-codes. Will still file a hassle factor form since our payment certainly hasn’t increased to account for the change to not pay for these supplies.
Any reply from the AAP hassel factor form submission to date?
No, not yet.