Medicare Program Integrity Manual (Pub. 100-08), Ch. 5 § 5.3

Master List of DMEPOS Items Potentially Subject to a Face- to-

Last amended: 2020Year: 2020Length: 169 wordsOfficial source
5.3 - Master List of DMEPOS Items Potentially Subject to a Face- to- Face Encounter and WOPD and/or Prior Authorization Requirements (Rev. 10190; Issued: 06-19-2020; Effective: 01-01-2020; Implementation: 07-01- 2020) 42 CFR 410.38 and Final Rule 1713 (84 Fed. Reg Vol 217) creates a “Master List of DMEPOS Items Potentially Subject to Face-To-Face Encounter and Written Order Prior to Delivery and/or Prior Authorization Requirements”. The Master List shall serve as a library of DMEPOS items from which items may be selected for inclusion on either the: • Required Face-to-Face Encounter and Written Order Prior to Delivery List; or • Required Prior Authorization List. Items included in either Required List are subject to the face-to-face encounter and WOPD or prior authorization requirements, respectively, as a condition of payment. See Chapter 3 for instructions regarding the requirements for items selected and included on the Required Prior Authorization List. The following instructions are limited to those items selected and included on the Required Face-to-Face Encounter and Written Order Prior to Delivery List.
Medicare Program Integrity Manual (Pub. 100-08), Ch. 5 § 5.3: Master List of DMEPOS Items Potentially Subject to a Face- to- | Justis AI