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MIR-2007-5A, May 2007
MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
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New "K" Codes for Oral/Mask for Use with Continuous Positive Airway Pressure (CPAP) Device
Provider Types Affected
Providers and suppliers submitting claims to Medicare contractors (fiscal intermediaries (FI), Durable Medical Equipment Regional Carrier (DMERC), DME Medicare Administrative Contractors (DME MAC)), for services to Medicare beneficiaries for CPAP
Provider Action Needed
Be sure billing staff are aware that, effective July 1, 2007, three new “K” codes will be established for oral/mask for use with a CPAP device.
Background
This article is based on Change Request (CR) 5525 and you need to be aware that effective July 1, 2007, the following codes will be added to the system, i.e.:
K0553 |
Combination oral/nasal mask, used with continuous positive airway pressure device, each |
K0554 |
Oral cushion for combination oral/nasal mask, replacement only, each |
K0555 |
Nasal pillows for combination oral/nasal mask, replacement only, pair |
Additional Information
If you have questions, please contact your Medicare FI, DME MAC, DMERC, or A/B MAC at their toll-free number, which may be found at: http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip  on the CMS Web site.
To see the official instruction (CR5525) issued to your Medicare FI, DME MAC, DMERC, or A/B MAC, go to http://www.cms.hhs.gov/Transmittals/downloads/R1210CP.pdf  on the CMS Web site.
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents
MLN Matters Number: MM5525
Pub. 100-4, Transmittal# R1210CP, CR# 5525
Related CR Release Date: March 23, 2007
Effective Date: July 1, 2007
Implementation Date: July 2, 2007
Do you have your NPI? National Provider Identifiers (NPIs) will be required on claims sent on or after May 23, 2007. Every health care provider needs to get an NPI. Learn more about the NPI and how to apply for an NPI by visiting http://www.cms.hhs.gov/NationalProvIdentStand/  on the CMS Web site.
| CPT five-digit codes, descriptions, and other data only are copyright 2006 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medic services. AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS clauses apply. |
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