(Medicare Claims Processing Manual Crosswalk)

30.2.1 A3-3629 Daily Payment for ContinuousPassive Motion (CPM) Devices 20          30.3 A3-3629 Certain Customized Items20          30.4 A3-3629 Other Prosthetic and OrthoticDevices 20          30.5 B3-5102,5102.1 Capped Rental Items20    30.5.1 B3-5102,5102.1      Capped Rental Fee Variation by Month of Rental 20          30.5.2 B3-5102,5102.1 Purchase Option for CappedRental Items 20           30.5.3 Additional Purchase Option forElectric Wheelchairs 20          30.5.3.1 ExhibitsNew Chap. New  Sect. Int.  Pub 13 Carrier Pub 14 OPT Pub09 HO Pub 10 HHA Pub 11 SNF Pub 12 Other Source Description 20          30.5.4 Payments for Capped RentalItems During a Period of Continuous Use 20          30.5.5 Payment for Power-OperatedVehicles that May Be Appropriately Used as Wheelchair 20         30.6 B3-5102.1 Oxygen and Oxygen Equipment20         30.6.1 B3-5102.1 Adjustments to Monthly OxygenFee 20         30.6.2 B3-5102.1 Purchased Oxygen Equipment20          30.6.3 B3-5102.1 Contents Only Fee20           30.7 B3-5017 B-01-54 Payment for Parenteral andEnteral Nutrition (PEN) Items and Services 20           30.7.1 B3-5017 Payment for Parenteral andEnteral Pumps 20           30.7.2 B3-5017 Payment for PEN Supply Kits20         30.8 A3-3644  B3-4272,4272.1, 3045.7 Payment for Home DialysisSupplies and Equipment New Chap. New  Sect. Int.  Pub 13 Carrier Pub 14 OPT Pub09 HO Pub 10 HHA Pub 11 SNF Pub 12 Other Source Description 20          30.8.1 AB-01-61  DMERC, Carrier andIntermediary Determination of ESRD Method Selection 20         30.8.2 B3-5105.1 Installation and Delivery Chargesfor ESRD Equipment 20         40 Title only-no xref Payment for Maintenance and Service for Non-ESRD Equipment 20        e neral 40.1 B3-5102.2G, 5102.3 G20           40.2 A3-3629 Maintenance and Service ofCapped Rental Items 20          40.3 B3-5017.4 Maintenance and Service of PENPumps 20          50 B3-5102.2B Payment for Replacement ofEquipment 20           50.1 A3-3629 Payment for Replacement ofCapped Rental Items 20          50.2 AB-01-06  Payment for Replacement ofProsthetic Devices 20           50.3 B3-3324 Payment for Replacement ofParenteral and Enteral Pumps New Chap. New  Sect. Int.  Pub 13 Carrier Pub 14 OPT Pub09 HO Pub 10 HHA Pub 11 SNF Pub 12 Other Source Description 20           60 B3-5105 Payment for Delivery andService Charges for Durable Medical Equipment 20          80 B3-5106.1 Penalty Charges for LatePayment Not Included in Reasonable Charges or Fee Schedule Amounts 20         90 B3-5107 AB-02-114  Payment for Additional Expensesfor Deluxe Features 20       100 B3-4107.1, 4107.8 HHA-463 MedicareHandbook for New Suppliers: Getting Started, B-02-31  General Documentation Requirements 20 100.1  PIM      Written Order Prior to Delivery 20        100.2 B3-3312,3324, 4105, 4450  Certificates of Medical Necessity (CMN)  20          100.2.1  Completion of Certificate ofMedical Necessity Forms 20         100.2.2  B3-3324 Evidence of Medical Necessityfor Parenteral and Enteral Nutrition (PEN) Therapy New Chap. New  Sect. Int.  Pub 13 Carrier Pub 14 OPT Pub09 HO Pub 10 HHA Pub 11 SNF Pub 12 Other Source Description 20          100.2.2.1 Scheduling and DocumentingCertifications and Recertifications of Medical Necessity for PEN 20 100.2.2.2        Completion of the Elements of PEN CMN 20 100.2.2.3  B3-4450      DMERC Review of Initial PEN  Certifications 20         100.2.3  B3-4105 Evidence of Medical Necessityfor Oxygen 20          100.2.3.1 Scheduling and DocumentingRecertifications of Medical Necessity for Oxygen 20          100.2.3.2 HHA Recertification for HomeOxygen Therapy 20          100.2.3.3 Contractor Review of OxygenCertifications 20         100.3 B-02-031  Limitations on DMERCCollection of Information 20           110 A3-3629 General Billing Requirements -for DME, Prosthetics, Orthotic Devices, and Supplies 20        110.1 A3-3629 B-02-052,B-03-041  Billing/Claim Formats New Chap. New  Sect. Int.  Pub 13 Carrier Pub 14 OPT Pub09 HO Pub 10 HHA Pub 11 SNF Pub 12 Other Source Description 20           110.2 A3-3629 Application of DMEPOS FeeSchedule 20           110.3 B3-3011 Pre-Discharge Delivery ofDMEPOS for Fitting and Training 20 110.3.1        Conditions That Must Be Met 20 110.3.2        Date of Service for Pre-Discharge Delivery of DMEPOS 20         110.3.3  Facility Responsibilities Duringthe Transition Period 20           110.4 Frequency of Claims forRepetitive  Services (All Providers and Suppliers)  20         120 B3-3012 DMERCs  Billing Procedures Related To Advanced Beneficiary Notice (ABN) Upgrades  20    130 A3-3629  B3-4107.10 OPT 253.7 HO-441 HHA-463 SNF-260.4 (partial), SNF-264.4, SNF-533, SNF-534, AB-01-126  Billing for Durable Medical Equipment (DME) and Orthotic/ Prosthetic Devices New Chap. New  Sect. Int.  Pub 13 Carrier Pub 14 OPT Pub09 HO Pub 10 HHA Pub 11 SNF Pub 12 Other Source Description 20          130.1 A3-3629 Provider Billing for Prostheticand Orthotic Devices 20        130.2 A3-3629  B3-4107.8 Billing for Inexpensive or OtherRoutinely Purchased DME 20        130.3 A3-3629  B3-4107.8 Billing for Items RequiringFrequent and Substantial Servicing 20        130.4 A3-3629  B3-4107.8 Billing for Certain CustomizedItems 20  130.5 A3-3629  B3-4107.8      Billing for Capped Rental Items (Other Items of DME) 20  130.6 A3-3629  B3-4107.7      Billing for Oxygen and Oxygen Equipment 20         130.6.1  Oxygen Equipment and ContentsBilling Chart 20           130.7 A3-3629 Billing for Maintenance andServicing  (Providers and Suppliers) 20          130.8 A3-3629 Installment Payments20           130.9 Showing Whether Rented orPurchased 20       140 Title-noXref   Billing for Supplies New Chap. New  Sect. Int.  Pub 13 Carrier Pub 14 OPT Pub09 HO Pub 10 HHA Pub 11 SNF Pub 12 Other Source Description 20        140.1 A3-3629 B-03-024,B-03-056  Billing for Supplies and Drugs Related to the Effective Use of DME 20     140.2 A3-3629 HO-228.3,  HHA-206.4, HHA-219.1, HHA-461 (partial) SNF-260.3  Billing for HHA Medical Supplies 20         140.3 B3-3045.7 Billing DMERC for HomeDialysis Supplies and Equipment 20          150 A3-3629 Institutional Provider Reportingof Service Units for DME and Supplies 20         160 A3-3660.6 Billing for Total ParenteralNutrition and Enteral Nutrition 20      160.1 A3-3660.6 HO-438,HO-229  HHA-403 SNF-544,SNF-559, SNF-260.4, SNF-261  Billing for Total Parenteral Nutrition and Enteral Nutrition Furnished to Part B Inpatients 20          160.2 A3-3660.6 SNF-368 Special Considerations for SNFBilling for TPN and EN Under Part B 20        170 AB-01-60,AB-01-126  Billing for Splints and Casts New Chap. New  Sect. Int.  Pub 13 Carrier Pub 14 OPT Pub09 HO Pub 10 HHA Pub 11 SNF Pub 12 Other Source Description 20          190 A3-3629  B3-5102 Contractor Application of FeeSchedule and Determination of Payments and Patient Liability for DME Claims 20           200 B3-3010 Automatic Mailing/Delivery ofDMEPOS 20        210 B-03-055  CWF Crossover Editing for DMEPOS Claims During an Inpatient Stay  20        220 No source  Appeals CMS requested x reference