SUPPLIER ALERT

Items Requiring Coding Verification Reviews by the PDAC

Manufacturers and suppliers are reminded that a number of items require coding verification review by the Pricing, Data Analysis and Coding (PDAC) contractor. As noted in the Local Coverage Determinations (LCD) and related Policy Articles that include these codes, claims for these Healthcare Common Procedure Coding System (HCPCS) codes will be denied if the products requiring coding verification review are not listed on the PDAC Product Classification List. Coding decisions are updated frequently. Suppliers should refer to the Product Classification List often to ensure Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items billed have been coded by the PDAC. The Product Classification List is located on Durable Medical Equipment Coding System (DMECS) which is located on the PDAC web site at: https://www.dmepdac.com/dmecs/index.html

The table below reflects the current list of HCPCS codes that require coding verification review by the PDAC along with the applicable LCD or Advisory Article for the code(s) and the date (i.e., claims with dates of service on or after) for when the requirement became effective

E0650PNEUMATIC COMPRESSOR, NON-SEGMENTAL HOME MODEL1/1/06
E0651PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL
WITHOUT CALIBRATED GRADIENT PRESSURE
1/1/06
E0652PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL
WITH CALIBRATED GRADIENT PRESSURE
1/1/06
A6545GRADIENT COMPRESSION WRAP, NON-ELASTIC,
BELOW KNEE, 30-50 MM HG, EACH
1/1/09

The PDAC coding verification applications required for these products are located on the PDAC website at: https://www.dmepdac.com/review/apps_check.html