DME MACs Instructed to Deactivate Accreditation Edit

The Centers for Medicare & Medicaid Services (CMS) have told the four DME MACs to deactivate the edit related to accreditation files for DME suppliers.

The accreditation edit was resulting in incorrect "B7" denials of DME claims. A news update sent out last week by National Government Services (NGS), the Jurisdiction B DME MAC, said the denials are thought to have been caused by "an error in the supplier accreditation files used by the DME MACs to process claims."

Claims processed on or after July 19, 2011, will no longer be denied due to the accreditation issue, the DME MACs said. NGS' bulletin added, "A date has not yet been received as to when the DME MACs should resume the editing for accreditation. However, the editing will resume once a permanent solution to this issue has been determined."

DME suppliers who incorrectly received B7 denials - which state in the Remittance Advice, "This provider was not certified/eligible to be paid for this procedure/service on this date of service" - will not have to re-submit claims, the DME MACs have said.

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