Adding Durable Medical Equipment (DME) to a chiropractic practice has been one avenue that offices have used as an additional revenue stream. The National Supplier Clearinghouse, part of Palmetto GBA, is the DME section of Medicare.
Chiropractors can apply for and be granted a supplier number to provide durable medical equipment, such as back braces, to Medicare enrollees and are able to be paid according to the Medicare approved price codes and limits.
Chiropractors desiring to add DME to their practice must do so by following a strict set of DME guidelines. These include:
- Written order
- Certificate of Medical Necessity (if applicable)
- DME Information Form
- Proof of delivery
- Beneficiary authorization
- ABN, if applicable
- Information from the treating physician concerning the patient’s diagnosis
- Additional documentation requiremen
Chiropractic physicians know that Medicare only covers manual manipulation of the spine to correct a subluxation; any other service or item ordered by a chiropractor is statutorily excluded and will be denied. This includes any order for durable medical equipment.
This means that DC’s dispensing durable medical equipment for Medicare will require an order, certificate of medical necessity and other documentation from an MD or other authorized provider. The dispensation of the product must follow the DME documentation guidelines required by Medicare.
In September 2012, the National Supplier Clearinghouse (NSC) announced a change in the DME accreditation rules. Chiropractors are eligible to enroll as DMEPOS suppliers but are no longer afforded any special enrollment exemptions extended to other physicians and non-physician practitioners identified in Section 1861(r) of the Social Security Act. Medicare coverage for a chiropractor is limited to the manual manipulation of the spine to correct a subluxation; all other services furnished or ordered by chiropractors are not covered. As such, chiropractors are not exempt from DMEPOS accreditation, surety bonds, enrollment fees, site visits or licensing requirements as required for a DMEPOS supplier in the state(s) in which they provide service.
NSC further announced that existing chiropractic DME suppliers must complete the accreditation process and obtain a surety bond to be recertified.
DME accreditation is a moderately complex process and requires full policy, procedure, and compliance programs are in place prior to a site visit that must be conducted before the entity can be accredited.
All of these changes do not effect your Medicare Part B provider enrollment, claims processing or current payment stream for manipulations!
For additional information on this or other billing, coding, documentation or compliance related issues – contact Cornerstone Medical Management. We are experienced providers of DME policy, procedure and compliance plans.