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Provider Notice issued 06/29/10
Revisions to the DME Supplies Required to be Billed Through the Pharmacy System
| To: | Participating Pharmacies |
| Date: | June 29, 2010 |
| Re: | Revisions to the DME Supplies Required to be Billed Through the Pharmacy System |
On May 4, 2009, the department issued an informational notice which required pharmacies enrolled to provide durable medical equipment and supplies to bill various medical supplies through the pharmacy system using the eleven-digit NDC. The department has reviewed the listing of supplies and has removed all ostomy supply products. The Durable Medical Equipment (DME) listing is posted on the department’s Web site and will be reviewed and updated annually.
Effective immediately, ostomy supply claims must be submitted through the Durable Medical Equipment (DME) claims processing system using the appropriate HCPCS code rather than through the pharmacy system using the NDC.
Providers who received rejections for ostomy supply claims submitted through the pharmacy system June 1, 2009, and after, may resubmit the claim for payment through the DME system. The department will grant exceptions to the 12-month filing requirement through September 1, 2010, to allow providers time to submit claims and receive payment for these services. Claims past the 12-month filing requirement must be submitted on a paper claim form with a letter attached requesting a time override due to change in policy and sent to the following address.
Bureau of Comprehensive Health Services
Attn: Durable Medical Equipment
P.O. Box 19124
Springfield, Illinois 62794-9124
If you have any questions concerning this notice, please contact a pharmacy or durable medical equipment billing consultant at 1-877-782-5565.
Theresa A. Eagleson, Administrator
Division of Medical Programs