Remark code M93 indicates that the documentation provided confirms there was an interruption in the use of the medical equipment, which has resulted in the initiation of a new capped rental period starting from the date the equipment was delivered.
Common causes of code M93 are situations where there has been a significant pause or discontinuation in the use of durable medical equipment (DME), leading to the initiation of a new rental period upon the delivery of new equipment. This could be due to the patient no longer needing the equipment for a period of time, the equipment being lost or damaged beyond repair, or a clinical reassessment indicating a different type of equipment is now necessary. Additionally, if the patient was hospitalized and the equipment was not used during the stay, this could also trigger a new rental period upon discharge and subsequent re-delivery of the equipment.
Ways to mitigate code M93 include ensuring that documentation clearly indicates the medical necessity for a new rental period without suggesting an unintended break in therapy. It's important to maintain accurate and continuous usage records, and to verify that the equipment delivery aligns with the start of a new rental period. Regularly review and update the patient's treatment plan to reflect any changes in their condition that would necessitate new equipment. Additionally, provide thorough training for staff responsible for equipment orders and claims submissions to avoid administrative errors that could imply a break in therapy when there isn't one.
The steps to address code M93 involve verifying the patient's equipment delivery records and rental period details. Ensure that the documentation accurately reflects the break in therapy and the initiation of a new rental period. Update the patient's account and billing records to align with this information. If the break in therapy and new rental period are correctly documented, resubmit the claim with any additional supporting information that clarifies the situation. If the documentation does not support the claim, make the necessary corrections before resubmission. It may also be beneficial to communicate with the equipment provider to confirm the details of the delivery and rental period start date to ensure all information is consistent and accurate.