Here’s one change to look out for on Dec. 1, when the proposed changes to the ASC X12 claim form is released: The new format could require providers to include the device identifier (DI) segment of the unique device identifier for implanted devices such as pacemakers or defibrillators.
The HHS Office of Inspector General (OIG) is pushing for the addition in an “
early alert” issued Sept. 30 and addressed to CMS Acting Administrator Andrew Slavitt.
OIG discovered during a recent audit of recalls of seven unnamed cardiac devices that based on claims data alone, there was no easy way to track what specific device was implanted and whether a device replacement was due to a recall or some other reason, the agency stated.
Instead, OIG auditors “had to establish complex audit procedures and undertake the labor-intensive process of obtaining and reviewing the device recipients medical records” to figure out the reasons for the replacements, the agency said.
“Inclusion of the DI portion of the [unique device identifier] on claim forms would be an important step in the identification of the model and manufacturer of an implanted device,” OIG concluded.
CMS appears to concur with that and recently co-signed a letter with the FDA that supports capturing the DI on claim forms, according to OIG. –
Laura Evans, CPC (levans@decisionhealth.com)