Durable Medical Equipment and Medical Supplies
Contents
PART 2 – MEDI-CAL BILLING AND POLICY
FOR ALLIED HEALTH SERVICES
The Contents is a list of sections contained in the Part 2manual, Allied Health for Durable Medical Equipment and Medical Supplies. Section titles appear in alphabetical order. The “locator key” is an abbreviated form of the section title at the top of each page for skimming and identifying sections. For detailed topic entries within Part 1 and Part 2, refer to the Manual Index in the Indexes and Glossary manual.
Section Title Locator Key
A
Appeal Form Completion...... appeal form
C
California Children’s Services (CCS) Program...... cal child
California Children’s Services (CCS) Program Approved Hospitals...... cal child appr
California Children’s Services (CCS) Program Billing...... cal child bil
CCS Program Billing Guidelines
California Children’s Services (CCS) Program Billing Example:
CMS-500...... cal child bil cms
California Children’s Services (CCS) Program County Office Directory....cal child county
California Children’s Services (CCS) Program Eligibility...... cal child elig
California Children’s Services (CCS) Program Medical Therapy Program...cal child med
California Children’s Services (CCS) Program Provider Paneling...... cal child panel
Individual Provider Paneling Application for Physicians and Podiatrists
Individual Provider Paneling Application for Allied Health Care Professionals
California Children’s Services (CCS) Program Referrals...... cal child ref
(continued)
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Medical Supplies Billing and PolicyMay 2007
Durable Medical Equipment and Medical Supplies
Contents
PART 2 – MEDI-CAL BILLING AND POLICY
FOR ALLIED HEALTH SERVICES
Section TitleLocator Key
C
California Children’s Services (CCS) Program Service Authorization
Request (SAR)...... cal child sar
New Referral CCS/GHPP Client Service Authorization Request (SAR)
Established CCS/GHPP Client Service Authorization Request (SAR)
CCS/GHPP Discharge Planning Service Authorization Request (SAR)
California Children’s Services (CCS) Program Service Code Groupings.....cal child ser
California Children’s Services (CCS) Program Special Care Centers...... cal child spec
California Code of Regulations (CCR), Title 22, Section 51003,
Prior Authorization...... access on Internet at
California Code of Regulations (CCR), Title 22, Section 51485,
Submission of False Information...... access on Internet at
California Code of Regulations (CCR), Title 22, Section 51520,
Medical Supplies...... access on Internet at
CIF Completion...... cif co
CIF Special Billing Instructions...... cif sp
CIF Submission and Timeliness Instructions...... cif sub
CMS-1500 Completion...... cms comp
CMS-1500 Special Billing Instructions...... cms spec
CMS-1500 Submission and Timeliness Instructions...... cms sub
CMS-1500 Tips for Billing...... cms tips
Correct Coding Initiative: National...... correct
Correct Coding Initiative: National – Claim Preparation...... correct cod
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Medical Supplies Billing and PolicyMay 2007
Section TitleLocator Key
D
Durable Medical Equipment (DME): An Overview...... dura
Certificate of Medical Necessity for All Durable Medical Equipment (DME)
Certificate of Medical Necessity for Apnea Monitors
Certificate of Medical Necessity for Nebulizers
Certificate of Medical Necessity for Oxygen
Durable Medical Equipment (DME): Bill for DME...... dura bil dme
Durable Medical Equipment (DME): Bill for Infusion Equipment...... dura bil inf
Durable Medical Equipment (DME): Bill for Oxygen
and Respiratory Equipment...... dura bil oxy
Durable Medical Equipment (DME): Bill for Therapeutic
Anti-Decubitus Mattresses and Bed Products...... dura bil thp
Durable Medical Equipment (DME): Bill for Wheelchairs
and Wheelchair Accessories...... dura bil wheel
Certificate of Medical Necessity for a Manual Wheelchair, Standard or Custom
Certificate of Medical Necessity for a Motorized Wheelchair, Custom or Standard
Certificate of Medical Necessity for a Power Operated Vehicle (POV) aka
Scooter, Standard or Bariatric
Durable Medical Equipment (DME):
Billing Codes and Reimbursement Rates...... dura cd
Durable Medical Equipment (DME): Billing Codes
for California Children’s Services (CCS)...... dura cd ccs
Durable Medical Equipment (DME) Billing Codes:
Frequency Limits...... dura cd fre
Durable Medical Equipment (DME): Billing Examples...... dura ex
Durable Medical Equipment (DME): Wheelchair
and Wheelchair Accessories Guidelines...... dura wheel guide
E
Enteral Nutrition Products...... enteral
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Medical Supplies Billing and PolicySeptember 2015
Section TitleLocator Key
F
Forms: Legibility and Completion Standards...... forms leg
Forms Reorder Request: Guidelines...... forms reo
Forms Reorder Request: Medical Services and Allied Health...... forms reo ma
G
Genetically Handicapped Persons Program (GHPP)...... genetic
H
HCPCS Introduction...... hcpcs
HCPCS Level III Interim Code List: Reimbursable Medi-Cal-Only Codes...... hcpcs iii
I
Incontinence Medical Supplies...... incont
Incontinence Medical Supplies Example: CMS-1500...... incont ex
Incontinence Supplies Prescription Form: Completion...... incont sup com
Incontinence Supplies Prescription Form
Intravenous or Intra-arterial Solutions: Administration Sets...... iv sol admin
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Medical Supplies Billing and PolicyDecember 2005
Section TitleLocator Key
M
Medical Supplies...... mc sup
Medical Supplies: Billing Examples...... mc sup ex
Medicare/Medi-Cal Crossover Claims: CMS-1500...... medi cr cms
Medicare/Medi-Cal Crossover Claims:
CMS-1500 Billing Examples for Allied Health...... medi cr cms exa
Medicare/Medi-Cal Crossover Claims:
Medi-Cal Pricing Examples for Allied Health...... medi cr cms pra
Medicare/Medi-Cal Crossover Claims: UB-04...... medi cr ub
Medicare/Medi-Cal Crossover Claims: UB-04 Billing Examples...... medi cr ub ex
Medicare Non-Covered Services: Charts Introduction...... medi non cha
Medicare Non-Covered Services: HCPCS Codes...... medi non hcp
Modifiers: Approved List...... modif app
O
Optional Benefits Exclusion...... opt ben exc
Orthotic and Prosthetic Appliances: Billing Codes and
Reimbursement Rates – Orthotics...... ortho cd1
Orthotic and Prosthetic Appliances: Billing Codes and
Reimbursement Rates – Prosthetics...... ortho cd2
Orthotics and Prosthetics: Frequency Limits for Orthotics...... ortho cd fre1
Orthotics and Prosthetics: Frequency Limits for Prosthetics...... ortho cd fre2
Other Health Coverage (OHC)...... oth hlth
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Medical Supplies Billing and PolicyFebruary 2015
Section TitleLocator Key
P
Provider Billing after Beneficiary Reimbursement (Conlan v. Shewry)...... prov bil
R
Remittance Advice Details (RAD)...... remit adv
Remittance Advice Details (RAD) Examples:
Allied Health and Medical Services...... remit ex am
Remittance Advice Details (RAD): Payments and Claim Status...... remit pay
Respiratory Care...... respir
S
Share of Cost (SOC): CMS-1500...... share cms
Sign Language Interpretation...... sign
Speech Generating Devices (SGD)...... spe dev
T
TAR Completion...... tar comp
TAR Criteria for NF Authorization (Valdivia v. Coye)...... tar crit nf
TAR Deferral/Denial Policy (Frank v. Kizer)...... tar defer
TAR Field Office Addresses...... tar field
TAR Submission: Transmittal Form...... tar submis
TAR: Submitting Appeals...... tar submit
Taxable and Non-Taxable Items...... tax
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Medical Supplies Billing and PolicyFebruary 2015