05/15/2019    Ron Werter, DPM

Website for Checking Same or Similar DME

What is the site where we can see if the patient
has had a same or similar DME under Medicare?
Searching doesn't seem to find it.

Ron Werter, DPM, NY, NY

Response: Each of the Medicare Administrative
Contractors (as per CMS requirements) has a
provider portal. Both portals have some learning
curve to navigate. Signing up for the Noridian
Portal is easier (but still somewhat of a
challenge) and can be accomplished in under an
hour. You can be up and running on the same date
or within a few days of application submission.
My CGS takes longer, due to the fact that it
takes some time for CGS to respond to the
applicant with a "token number" which is required
to compete their application. Once the token
number is plugged into a started application,
your ability to use the My CGS portal is
activated and ready to use.

Both portals have access limitation parameters
which are useful for the practice manager to set
based on the level of access you wish them to
have.

Noridian (Region A&D) has an actual Provider
Portal with a Same or Similar Button. Here you
can input the patient's demographics, date range
(I would go back 5 years) and a range of HCPCS
codes. If something of a "Same or Similar" code
was provided, the portal will provide details on
the HCPCS code, narrative, date of dispensing and
who supplied the particular item.

The "Same or Similar" results will be limited
only to services provided by Noridian (both
Regions A&D). Thus it is imperative that you also
sign up for "My CGS" which performs the same
search parameters as the Noridian Portal. My CGS
is a bit more complicated to use, but
nevertheless provides the same (or similar -no
pun intended) to the Noridian Portal. In the My
CGS portal one has to search under the patient's
claim history and input an inquiry to obtain the
same results as those noted by the Noridian
Portal.

Performing a search in both portals allows the
provider to be as close as 100% possible to
ensure that the patient did not obtain a Same or
Similar device within the past five years.

I provided more detailed information on the Same
or Similar topic in the April 2019 Podiatry
Management issue.

Paul Kesselman, DPM, Woodside, NY

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