New Modifiers and Other Updates From Oxygen LCD that Suppliers Should Note
WASHINGTON, D.C. – Due to the updated Oxygen and Oxygen Equipment Local Coverage Determination (LCD L33797) that went into effect on January 1, 2023, there are several changes. CMS is no longer requiring Certificate of Medical Necessity (CMN). This removal is effective for claims with a date of service beginning January 1, 2023. Suppliers that continue to submit their oxygen claims with CMN will be frontend rejected.
DME MACs published Correct Coding – Submitting Oxygen Claims with Modifiers KX, GA, GY, and GZ – Revised, reminding suppliers of the use of the new modifiers indicating whether a beneficiary meets the reasonable and necessary coverage requirement. Claim lines that are submitted without a KX, GA, GY, or GZ modifier will be frontend rejected.
Defense Health Agency Announces TRICARE Contract Awards for 2024
WASHINGTON, D.C. – The Defense Health Agency (DHA) recently announced new TRICARE contract awards taking effect in 2024. The Eastern region will continue to be served by Humana Military and the West will transition to TriWest from current contractor Health Net Federal Services, a Centene subsidiary. TriWest previously held TRICARE contracts with the DoD for 17 years, beginning in 1996 through 2013.
In addition, six states are transitioning from East to West region: Arkansas, Illinois, Louisiana, Oklahoma, Texas, and Wisconsin. The DHA has targeted Jan 2024 for the changes to take place. AAHomecare will monitor the transition, especially with regards to impacts and requirements for HME suppliers. See the DHA announcement for more details.