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CMS-1403-FC §424.44 Time limits for filing claims. (a) Basic Limits. Except as provided in paragraph (b) and (e) of this section, the claim must be delivered to the intermediary or carrier as appropriate: * * * * * (e) Exceptions. Any claims filed by the following suppliers with Medicare billing privileges whose time limits for filing claims are linked to their enrollment status and are governed under §424.516, §424.520, and §424.521 of this subpart: (1) Physician or nonphysician organizations. (2) Physicians. (3) Nonphysician practitioners. (4) Independent diagnostic testing facilities. Subpart D--To Whom Payment is Ordinarily Made 39. Section 424.57 is amended by-- A. Amending paragraph (a) by adding the definitions of “Affiliate”, “Attended facility-based polysomnogram”, “Continuous positive airway pressure (CPAP)” device, and “Sleep test” in alphabetical order. B. Adding new paragraph (f). The additions read as follows: 1136
CMS-1403-FC §424.57 Special payment rules for items furnished by DMEPOS suppliers and issuance of DMEPOS supplier billing privileges. (a) * * * Affiliate means a person or organization that is related to another person or organization through a compensation arrangement or ownership. Attended facility-based polysomnogram means a comprehensive diagnostic sleep test including at least electroencephalography, electro-oculography, electromyography, heart rate or electrocardiography, airflow, breathing effort, and arterial oxygen saturation furnished in a sleep laboratory facility in which a technologist supervises the recording during sleep time and has the ability to intervene if needed. * * * * * Continuous positive airway pressure (CPAP) device means a machine that introduces air into the breathing passages at pressures high enough to overcome obstructions in the airway in order to improve airflow. The airway pressure delivered into the upper airway is continuous during both inspiration and expiration. * * * * * 1137
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<strong>CMS</strong>-1403-FC<br />
§424.57 Special payment rules for items furnished by DMEPOS<br />
suppliers and issuance of DMEPOS supplier billing<br />
privileges.<br />
(a) * * *<br />
Affiliate means a person or organization that is<br />
related to another person or organization through a<br />
compensation arrangement or ownership.<br />
Attended facility-based polysomnogram means a<br />
comprehensive diagnostic sleep test including at least<br />
electroencephalography, electro-oculography,<br />
electromyography, heart rate or electrocardiography,<br />
airflow, breathing effort, and arterial oxygen saturation<br />
furnished in a sleep laboratory facility in which a<br />
technologist supervises the recording during sleep time and<br />
<strong>has</strong> the ability to intervene if needed.<br />
* * * * *<br />
Continuous positive airway pressure (CPAP) device<br />
means a machine that introduces air into the breathing<br />
passages at pressures high enough to overcome obstructions<br />
in the airway in order to improve airflow. The airway<br />
pressure delivered into the upper airway is continuous<br />
during both inspiration and expiration.<br />
* * * * *<br />
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