Navigating through Medicare qualifications for closed-system intermittent catheters*
The Medicare Urological Local Coverage Determination (LCD 33803) outlines coverage criteria for intermittent catheters. The qualification requirements for closed-system catheters are more complex compared to straight and coudé intermittent catheters. This webinar will bring awareness to all five qualification requirements for closed-system intermittent catheters (A4353). Furthermore, we will emphasize the importance of medical documentation and discuss proven appeal and audit strategies.
Presenters
Noel Neil
VP of Auditing and Corporate Compliance at ACU-Serve Corp.
Noel has been in the DMEPOS industry for over 16 years working in the intake, billing and compliance departments. He serves on various Medicare provider outreach and education advisory groups and Medicare and industry councils. Noel is a frequent speaker at Medtrade and various state associations on many different topics. Currently, Noel serves as the Vice President of Auditing and Corporate Compliance at ACU-Serve Corp., where he is responsible for implementing and monitoring of the company’s corporate compliance program. He also offers audit defense and policy specific education and guidance to ACU-Serve’s existing clients. He represents multiple suppliers in practically all types of Medicare audits from initial request to the Administrative Law Judge (ALJ), and in some cases the Depart of Appeals Board (DAB). Noel received a Juris Master’s (JM) Law Degree from Florida State University College of Law with a concentration in healthcare regulation. Noel is also a Board of Certification/Accreditation (BOC) Certified Durable Medical Equipment Specialist (CDME) and a subject matter expert (SME) for the 2021-2022 revision of the CDME exam. Noel enjoys interacting with suppliers and breaking down seemingly complex policies in simpler terms most suppliers can relate to.
Anna Markiewicz
Sr. Manager Payor Relations at Coloplast
Anna has been in the market access/reimbursement field for over fifteen years and has knowledge of the US healthcare reimbursement and billing systems. She has worked in the DMEPOS/market access industry for 11 years with various responsibilities globally and within the US. Anna has served on industry councils and patient and state associations. Throughout her career she has managed evidence generation activities including global end user surveys related to intermittent catheterization and ostomy supplies. Currently, Anna is a Sr. Manager of Payor Relations at Coloplast and focuses on improving end user access and coverage for intermittent catheters and ostomy supplies.
Disclaimer
*Noel Neil is an AcuServe employee and has not received compensation from Coloplast to provide this information. Each person’s situation is unique so your experience may not be the same.
Coloplast Corp. provides this information for convenience and your general reference only. It does not constitute legal advice or a recommendation regarding clinical practice. Reimbursement, coverage, and payment policies can vary from one insurer and region to another and is subject to change without notice. The provider has the responsibility to determine medical necessity and to submit appropriate codes and charges for care provided. Coloplast does not guarantee coverage or payment of products and Coloplast makes no guarantee that the use of this information will prevent differences of opinion or disputes with Medicare, insurers, or other payers as to the correct form of billing or the amount that will be paid. This information is provided for your general information only and is not intended to replace any advice you receive from your own internal or external insurance coverage consultants, reimbursement specialists or legal counsel.