Tips for billing for equipment that has been stolen, destroyed in a disaster, or ordered but not furnished
Theft:
If a beneficiary has a durable medical equipment item stolen, replacement may be allowed by Medicare when the medical necessity of the item is reaffirmed with a doctor’s order and/or CMN, if necessary. When filing claims for this replacement equipment, the claim must state that the original equipment was lost due to theft. A police report should be kept on file and it must be made available to the DMERC on request.
Natural Disaster:
When filing claims for beneficiary-owned equipment destroyed by a federal disaster (flood, hurricane, etc.), please remember to file a hardcopy claim with documentation stating the nature of the disaster and the damage the equipment suffered. At the top of the claim form, please indicate in large, bold letters, “DISASTER CLAIM” and the nature of the disaster, e.g., “flood claim.” Equipment owned by the supplier (rental equipment) should be replaced by the supplier under the rental agreement.
Salvage Claims:
A salvage claim is a claim that can be filed when artificial limbs, braces, and other custom made items are ordered but not furnished to a beneficiary. Valid reasons for filing a salvage claim are as follows:
- Beneficiary dies before custom made item is furnished;
- Beneficiary cancels order before custom made item is furnished;
- Custom made item order is no longer medically necessary or condition changes before item is furnished.
In order to receive payment for a salvage claim a new claim must be filed for the labor and the non-salvageable parts of the custom item. The provider must indicate on the claim or in the notepad that this is a salvage claim and the reason the item was ordered but not furnished.