National Government Services, the Jurisdiction B Durable Medical Equipment Medicare Administrative Contractor (DME MAC), has announced that it will begin rejecting claims that are incorrectly billed with a not otherwise classified (NOC) code if the item has an established Health Care Common Procedure Coding System (HCPCS) code. These claims will be rejected with American National Standards Institute (ANSI) code CO-16 with a reason code 51 which states: “Missing/incomplete/invalid procedure code(s).” In order to correct these claim rejections suppliers will be required to correct the HCPCS code and resubmit.
Durable medical equipment, prosthetic, orthotic and supplies (DMEPOS) suppliers can obtain guidance on the proper use of HCPCS coding through the Pricing, Data Analysis and Coding (PDAC) contractor website. DMEPOS suppliers can also reference the local coverage determinations (LCDs) and policy articles for assistance on correct coding by visiting the National Government Services website.
