Nonroutine Supply Editing

20.2.1 - Nonroutine Supply Editing (Rev. 2977, Issued; 06-20-14, Effective: 09-23-14; ICD-10: Upon Implementation of ICD-10, Implementation: 09-23-14; ICD-10: Upon Implementation of ICD-10) For home health consolidated billing, nonroutine medical supplies are identified as a list of discrete items by HCPCS code. Supplies are billed to DME MACs using the professional claim format, in which line items have both a ‘from’ and ‘to’ date. The line item ‘from’ date is used to enforce consolidated billing of nonroutine medical supplies. Claims submitted by providers using the institutional claim format may include a nonroutine supply HCPCS code in addition to the other services provided. These supplies are either bundled into the rate paid for the primary service or are otherwise incident to the primary service(s) being rendered, therefore these supplies do not fall within the bundling provisions of HH PPS. As a result, supplies reported on institutional claims are not subject to consolidated billing edits by CWF.