BALTIMORE, MD (Home Care Wire) Oxygen suppliers may have a little less claims trouble than they expected from a new requirement.

Last November, the Centers for Medicare & Medicaid Services established pre-payment autodenial edits for oxygen suppliers, the agency says in April 18 Transmittal No. 1493 (CR 5929).

The National Supplier Clearinghouse is supposed to “assign an oxygen specialty code to all suppliers who have indicated they will be providing oxygen and/or oxygen related services on their CMS 855S enrollment application,” CMS explains in the transmittal. Then DME MACs are supposed to “edit claims to look for the oxygen specialty code and submit a quarterly report of oxygen and/or oxygen related equipment DMEPOS supplier false claim submission attempts to CMS.”

Then “the NSC shall research the reported DMEPOS suppliers,” CMS says.

But the NSC will actually assign the codes only to suppliers in the 38 states that license or certify them for oxygen provision.

And the DME MACs now aren’t editing for the specialty codes, CMS says in a new MLN Matters Article (5929). “DME MACs are currently processing [oxygen] claims from enrolled and approved DMEPOS suppliers without regard to the specialty identified and services to be provided on the enrollment application form (CMS-855S),” CMS says.

The transmittal is at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5929.pdf. The article is at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5929.pdf.