Suppliers in Abingdon, VA

Jurisdiction D DME MAC Supplier Manual Chapter 2 – Supplier Enrollment This chapter outlines the requirements that a DME supplier must meet to receive payment in the Medicare program. All DME suppliers who serve Medicare beneficiaries and meet the supplier standards must apply for a supplier number. Find your Medicare Administrative Contractor's (MAC) website by selecting your place of business or MAC's name. Also included at the end of the “MAC Name” list are links to specialty contractors you may also interact with as a Medicare provider or supplier. To enroll as a Medicare DME supplier, there are requirements that must be met. View the National Supplier Clearinghouse (NSC) website to read articles, access learning & educational information, view resources and learn about Supplier enrollment related processes, rules, and regulations.

Lincare Inc Type: Durable Medical Equipment & Medical Supplies Supplier Location: 498 E Main St, Abingdon, Virginia 24210 Phone: (276) 676-2027

Ballad Health Pharmacy Type: Durable Medical Equipment & Medical Supplies Supplier Location: 16000 Johnston Memorial Dr, Abingdon, Virginia 24211 Phone: (276) 258-1990

Northgate Pharmacy Type: Pharmacy Location: 611 Campus Dr, Abingdon, Virginia 24210 Phone: (276) 628-2001

Cvs Pharmacy # 05505 Type: Durable Medical Equipment & Medical Supplies Supplier Location: 801 East Main Street, Abingdon, Virginia 24210 Phone: (276) 628-8119

Mac's Medical Equipment And Supplie Type: DME Supplier - Oxygen Equipment & Supplies Location: 26102 Lee Hwy, Abingdon, Virginia 24211 Phone: (276) 525-4622

Medicare Suppliers

Durable Medical Equipment & Medical Supplies

Also referred to as DME Suppliers. A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Community/Retail Pharmacy

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers; administer vaccinations; and provide other professional services associated with pharmaceutical care.

Prosthetic/Orthotic Supplier

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

HMSA policies and procedures regarding billing requirements and claims filing instructions for durable medical equipment (DME) are consistent with Medicare DME policies except where otherwise specified in the Provider E-Library.

Ophthalmological Benefits

Vision appliances, including contact lenses, are covered as a prosthetic device as outlined in the DME MAC Jurisdiction D Supplier Manual. Eye examinations and appliances for routine refraction are not covered as a medical benefit, but may be covered as a benefit of the member's vision rider, if applicable.

Covered items include:

• Scleral cover shells. Scleral cover shells (HCPCS code V2627) will be considered for coverage as a DME medical benefit when they are medically necessary as an artificial support to a shrunken and sightless eye or as a protective barrier in the treatment of severe dry eye.

• Refractive lenses.

  Refractive lenses, including hydrophilic contact lenses (HCPCS, V2520-V2523) are covered as a DME medical benefit when they are medically necessary to restore the vision normally provided by the natural lens of the eye of an individual lacking the organic lens because of surgical removal or congenital absence. Covered diagnoses are limited to pseodophakia (ICD-9-CM code V43.1; ICD-10-CM code Z96.1), aphakia (ICD-9-CM, 379.31; ICD-10-CM, H27.01,H27.02, H27.03), and congenital aphakia (ICD-9-CM, 743.35; ICD-10-CM, Q12.3). Lenses provided for other diagnoses will be denied as noncovered.

Claims Filing Information

Dme Mac Jurisdiction A Supplier Manual

Claims for scleral cover shells and refractive lenses must be submitted with a site-specific modifier - LT and/or -RT and modifier SC to indicate medical necessity and may require additional documentation. Some DME items also require benefit precertification or a certificate of medical necessity. For specific coverage and payment rules, please refer to the DME MAC Jurisdiction D Online Supplier Manual . The manual is available online at www.noridianmedicare.com/dme/news/manual/index.html.

Dme Mac Supplier Manual

Medicare Advantage Requirements

For an item to be covered by Medicare Advantage, a written signed and dated order must have been received by the supplier prior to the item being dispensed and a claim being filed. As Medicare Advantage is Medicare-based, DMERC/Medicare filing guidelines apply.