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[IP] RE: insulin-pumpers-digest V11 #964

Lisa Ann,Since you mentioned CCS, which is Animus' connection to Medicare. Are
you using an Animus pump? But.. did you wait 5 years to get your new
pump?But.. your supplies had to be confirmed by you or your doctor who treats
your diabetes? Yes, you are actually answering my question.. and it is new
since the LCD determination letter specifies that supplies are NOT paid for
unless you go see your doc within the last 90 days of your supply order. CCS
is "supposed" to get confirmation from your doc. that you saw him in the last
90 days, and specifically for a "diabetes related" visit, not just any old
visit. Further that your physician must be "qualified" to give diabetes
See (http://www.ngsmedicare.com/content.aspx?docid=21534)LCD for External
Infusion Pumps (L27215)

Charges for drugs administered by a DME infusion pump may only be billed by
the entity that actually dispenses the drug to the Medicare beneficiary and
that entity must be permitted under all applicable federal, state, and local
laws and regulations to dispense drugs. Only entities licensed in the state
where they are physically located may bill for infusion drugs. Drugs and
related supplies and equipment billed by a supplier who does not meet these
criteria will be denied as not medically necessary.

Best Regards, Tom

> Date: Wed, 29 Sep 2010 04:19:17 +0000
> From: email @ redacted
> Subject: Re: [IP] Medicare Insulin Pump and supplies approval
>  I've been on Medicare for years & rec'd a new pump this past Mqy. I already
> my doc every three months so that's no big deal to me. CCS calls to confirm
> supply order & ask when I last saw my doc. That's new.
> Sincerely,
> Lisa Ann & Velvet
> T1 '70, pumping '89
> MM523 (Revel)
> Sent via BlackBerry by AT&T
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