New Edits for Durable Medical Equipment, Orthotics and Prosthetics Claims

To align with the rendering provider guidelines specified in clinical coverage policy 5B, Orthotics and Prosthetics, effective Feb. 1, 2022, new edits will be added to the NCTracks system for Durable Medical Equipment (DME), Orthotics and Prosthetics claims. Claims that are submitted with the codes in the table below will be subject to the new edits. If claims are denied, providers will see EOB 01620 (THE RENDERING PROVIDER TAXONOMY SUBMITTED DOES NOT MEET THE BOARD CERTIFICATION REQUIREMENTS FOR THE HCPCS CODE BILLED. CONFIRM THAT THE APPROPRIATE HCPCS CODE AND TAXONOMY WERE BILLED. IF NECESSARY, CORRECT AND RESUBMIT) on their Remittance Advice (RA)

M22021 - R - 2452