How do I find out if member has same/similar on a DME HCPCs code E0486

Michael Vaughn said:

How do I find out if a member has same/similar on a DME HCPCs code E0486?

To check for same or similar DME for HCPCS E0486, just follow these quick steps:

• Check History: Look back 5 years in the member’s claims for E0486 or similar OSA gear like CPAP/BIPAP.
• Use the Portal: Hop on the Noridian Medicare Portal or your specific MAC's site to run a "Same or Similar" inquiry.
• Cross-Reference: Ensure the device is PDAC approved soundboard for that specific code.
• Confirm: If the portal is vague, call the payer's IVR line directly to avoid a denial.

Do you need the specific ICD-10 codes that pair with E0486 for a clean claim?

Michael Vaughn said:

How do I find out if a member has same/similar on a DME HCPCs code E0486?

To check for same or similar DME for HCPCS E0486, just follow these quick steps:

• Check History: Look back 5 years in the member’s claims for E0486 or similar OSA gear like CPAP/BIPAP.
• Use the Portal: Hop on the Noridian Medicare Portal or your specific MAC's site to run a "Same or Similar" inquiry.
• Cross-Reference: Ensure the device is PDAC approved soundboard for that specific code.
• Confirm: If the portal is vague, call the payer's IVR line directly to avoid a denial.

Do you need the specific ICD-10 codes that pair with E0486 for a clean claim?