Request Code Verification
To avoid a delay in the processing of coding verification applications, please give attention to the following guidelines, all instructions within the individual applications as well as the following links:
- Tips for Completing Coding Verification Applications
- Product Sample Requirements
- Items Requiring Coding Verification Reviews
- Coding Verification Process (flowchart)
- Review the associated Local Coverage Determination (LCD) and the related Policy Article that are published by the DME MACs to determine if the product being submitted qualifies for the code being requested. The LCDs are published on the Centers for Medicare & Medicaid Services (CMS) web site at http://www.cms.gov/center/coverage.asp. The LCDs can be searched by Contractor, State, or alphabetically.
- These same LCDs and Policy Articles are also posted on the DME MAC websites at
- Review any related coding Advisory Articles that have been published by the DME MACs or the PDAC (and former SADMERC).
- Applications are fillable and savable. Completing all required fields electronically prior to printing the form will ensure legibility and accuracy. Please send only one (1) copy of the coding verification application.
- Please DO NOT put the application in a binder, folder or page protector or staple. The application along with marketing literature and other supporting information should be held together with a paper or binder clip or by a rubber band.
- Review the checklist on the last page of each application to ensure all corresponding documentation/applicable product sample is included with the application.
- The PDAC will only accept 15 applications every 30 days per Manufacturer / Distributor. The timeframe is established from the PDAC receipt date. Applications over this limit will not be accepted. A new application, including product samples if required, will need to be resubmitted after the 30 days have transpired.
- If you need assistance or have questions on how to complete a coding verification application, contact the PDAC Contact Center.
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