LEEDer Group Inc.
8508 North West 66th St.
Miami, Florida 33166 USA

Phone Toll-free: 866.814.0192 or 305.436.5030
Fax Toll-free: 866.818.0373 or 305.436.0086
E-mail Address: orders {at] LEEDerGroup [dot] com

2015-02 Proof of Delivery Reminder

KYDEX-PRO

STRONGER

SAFER

LEEDerGroup.com

NHIC, Corp.
DME MAC A ListServe
For Immediate Release
February 12, 2015

Proof of Delivery Reminder – Joint DME MAC Publication
  • Recently during claims review it was noted that suppliers have a misunderstanding about the purpose of Proof of Delivery (POD). All items of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) require POD. Proof of delivery serves multiple purposes, the most obvious being confirmation that the beneficiary received the item for which Medicare was billed. In addition to confirming receipt of an item, POD also serves other functions in Medical Review, specifically the ability of contractor’s review staff to determine correct coding. As noted in the Documentation Section of the DME MAC local coverage determinations (LCDs):
    Proof of delivery (POD) is a Supplier Standard and DMEPOS suppliers are required to maintain POD documentation in their files. For medical review purposes, POD serves to assist in determining correct coding and billing information for claims submitted for Medicare reimbursement. Regardless of the method of delivery, the contractor must be able to determine from delivery documentation that the supplier properly coded the item(s), that the item(s) delivered are the same item(s) submitted for Medicare reimbursement and that the item(s) are intended for, and received by, a specific Medicare beneficiary.
  • To enable review staff to make a correct coding determination, there must be sufficient details about the item delivered to ascertain whether or not the item(s) on the detailed written order are the same item(s) included on the claim and coded with the correct HCPCS code. To accomplish this task, the POD must contain specific information about the products to make this determination. As noted in the DME MAC LCD Documentation Section for each of the three methods of delivery, one of the requirements for proper POD documentation is: Sufficiently detailed description to identify the item(s) being delivered (e.g., brand name, serial number, narrative description)
  • Reviewers often see a reiteration of the HCPCS code narrative on the POD form as the detailed description of the item, particularly for orthotics and prosthetics. This is NOT adequate for POD purposes. Simply restating the HCPCS code narrative description does not allow review staff to determine what specific item(s) is being billed and if it is coded correctly. The preferred method is use of a brand name and model number, brand name and serial number or manufacturer name and part number to identify the product. If this type of information is not available for the product, suppliers may use a detailed narrative description of the item; however, it must contain sufficient descriptive information to allow a proper coding determination. This “narrative description” of the item is not the HCPCS code narrative.
  • Proof of delivery documents that fail to properly identify DMEPOS products and allow reviewers to make a correct coding determination will be denied for insufficient delivery information.
    For questions about correct coding, contact the PDAC Contact Center at (877) 735-1326 during the hours of 8:30 a.m. to 4:00 p.m. CT, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form.