“I am a retired DPM and closed my business. Medicare is wanting recoupment on some DME items from 3 years ago. They can’t recoup it through the claims obviously since I’m not practicing. They are asking me to directly send in the money. Do I need to pay this and then appeal? Should I appeal and not pay? What are the rules in this situation?”
by Alivia Leatherman, Registry Clearinghouse Support
July 14, 2025
By justina
0 Comments
Description:
For MEX 5, the patient must be seen at least twice: once at the time of diagnosis to document the pain scale, and a second time to assess any decrease in pain. In order to document the patient’s pain, you must use the standardized pain scale 1-10. This measure tracks pain levels from the first visit to the last. No specific treatment is required—any intervention that effectively reduces the patient's pain is acceptable, the hammer toe diagnosis must be a part of the claim. Treatments may include surgery, changes in shoe gear, padding, and debride corns.