ResMed Reimbursement Fast Facts: Accessories

This guide provides essential information for understanding Medicare coding and coverage for accessories used with Positive Airway Pressure (PAP) and Respiratory Assist (RAD) devices. It details common accessories, their replacement schedules, and crucial authorization requirements.

Key Information for Suppliers

The document outlines medical necessity criteria for patient-owned PAP and RAD devices, emphasizing the importance of continuous use and clinical evaluations. It also provides recommended steps for resupplying patients, ensuring proper contact and documentation.

Billing Guidelines

Specific instructions are provided for billing a three-month supply of accessories, including requirements for claim submission, narrative additions, date of service fields, unit reporting, and modifier usage. Verification of all billing requirements and patient eligibility with the payer prior to billing is strongly advised.

For detailed billing information, refer to resources such as CGS Administrators, LLC:

• CGS Medicare Billing Reminder