Will the MAO-004 report contain DME encounter services?


Answer:

Yes. Durable Medical Equipment (DME) records (payer code 80887) are reported on the MAO-004 report and are filtered in the same way as professional records. If at least one of the accepted lines on the record has a Current Procedural Terminology (CPT)/ Healthcare Common Procedure Coding System (HCPCS) code that is on the list of acceptable CPT/HCPCS codes for filtering, then these records will be reported with an Allowed status and the diagnoses on the record will be considered for risk adjustment.   

Source: Help Desk Inquiry answered in June 2018


Last Updated: 06/01/2018