(Medicare Claims Processing Manual)

Hospitals that are located outside a CBA that furnish walkers and/or related accessories to travelling beneficiaries who live in a CBA must affix the J4 modifier to claims submitted for these items.   The J4 modifier should not be used by contract suppliers.  50.16 - Exception for Wheelchair Accessories Furnished with Non -Competitively Bid Wheelchair Base Equipment  (Rev.  3324, Issued: 08- 14-15, Effective: 07- 01-13, Implementation: 01- 04-16)  Effective for c laims with dates of service on or after July 1, 2013, competitively bid wheelchair accessories are paid in accordance with standard Medicare DMEPOS payment rules, not competitive bidding rules, when furnished with non- competitively bid wheelchair base equipment.Transmittals Issued for this Chapter   Rev #  Issue Date  Subject  Impl Date  CR#  R11427CP  05/20/2022  Claims Processing Manual Update - Pub. 100.04 for Elimination of Certificates of Medical Necessity (CMNs) and Durable Medical Equipment Forms (DIFs)  01/03/2023  12734  R11414CP  05/12/2022  Claims Processing Manual Update - Pub. 100.04 for Elimination of Certificates of Medical Necessity (CMNs) and Durable Medical Equipment Forms (DIFs) - Rescinded and replaced by Transmittal 11427  06/13/2022  12734  R3953CP  01/19/2018  Revisions to the Claims Processing for Grandfathered Oxygen Claims that Span Competitive Bidding Rounds  07/02/2018  10420  R3593CP  08/17/2016  Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP): Additional Instructions for the Implementation of Round 2 Recompete of the DMEPOS CBP and National Mail Order (NMO) Recompete  10/03/2016  9579  R3565CP  07/20/2016  Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP): Additional Instructions for the Implementation of Round 2 Recompete of the DMEPOS CBP and National Mail Order (NMO) Recompete - Rescinded and replaced by Transmittal 3593  10/03/2016  9579  R3500CP  04/28/2016  Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS ) Competitive Bidding Program (CBP): Additional Instructions for the Implementation of Round 2 Recompete of the DMEPOS CBP and National Mail Order (NMO) Recompete - Rescinded and replaced by Transmittal 3565  10/03/2016  9579  R3324CP  08/14/2015  Clarification of the Policy for Competitively -Bid Wheelchair Accessories Furnished with Non-Competitively Bid Wheelchair Base Equipment  01/04/2016  9272  R2979CP  06/27/2014  Update to Pub. 100 -04, Chapter 36 to Provide Language -Only Changes for Updating ASC X12  07/28/2014  8771  R2231CP  05/27/2011  Phase 3 of Manual Revisions to Reflect Payment Changes for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) 08/28/2011  7401  Rev #  Issue Date  Subject  Impl Date  CR#  Items as a Result of the DMEPOS Competitive Bidding Program and the Deficit Reduction Act of 2005  R1544CP  06/26/2008  Manual Revisions to R eflect Special Billing Instructions for DMEPOS Items as a Result of the DMEPOS Competitive Bidding Program  07/07/2008  6007  R1532CP  06/11/2008  Phase 2 of Manual Revisions to Reflect Payment Changes for DMEPOS Items as a Result of the DMEPOS Competitive Bidding Program and the Deficit Reduction Act of 2005  07/07/2008  6119  R1502CP  05/09/2008  Initial Release of Chapter -Competitive Bidding  06/09/2008  5978  Back to top of chapter