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RAD Medical Billing Categories Will Change

RAD Medical Billing Categories Will Change

Published by: Melissa Clark, CCS-P on February 24, 2006

RAD Medical Billing Categories Will Change

Two new durable medical equipment codes will receive medical billing caps . Therapy services and durable medical equipment services have gone through many changes over the last year. The Centers for Medicare and Medicaid services have recently changed the category of two medical billing device codes: E0471 and E0472.

The medical billing codes E0471 and E0472 are RAD codes. These codes used to be placed in the durable medical equipment category that was for items frequently used. The Centers for Medicare and Medicaid services announced that this change will take effect on April 01, 2006.

The main reason CMS changed the category was because they no longer classified RADs in the same category as backup rate and bi-level capability items. This type of equipment requires frequent and mandatory servicing. An RAD system does not.

Beginning on April 1, the first claim submitted for the patient will be considered the first month rental in the cap period. Suppliers that use RADs should probably start using the cap modifiers KI, KH, and KJ beginning on April 01, 2006 as well.

The Centers for Medicare and Medicaid services are trying to streamline the medical billing and coding process for 2006. This new durable medical equipment change is just one step towards their goal. This shouldn’t really change the way you perform medical billing on RAD devices. Just remember they fit into a different category and medical billing reimbursement caps will apply. Also remember you may use modifiers to append your medical billing codes.

As long as your practice stays flexible, your medical billing will thrive. Ongoing training and constant reinforcement should keep your practice up to date. Change is the only constant and medical billing.

Published by: on February 24, 2006

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