Attention Medical Suppliers of the Omnipod Disposable Insulin Pump

Pity anyone who has to use the MDHHS billing system. This released on May 24.

Attention Medical Suppliers of the Omnipod Disposable Insulin Pump:

Michigan Department of Health and Human Services (MDHHS) has identified an error in L-letter L23-15 (effective April 1, 2023) which indicates a quantity limit of 10 pods per month rather than 15 pods per month for the Omnipod, disposable insulin pump. The Medicaid Code Rate and Reference Tool has been updated to reflect the correct quantity limits. MDHHS will reprocess all impacted claims received on or before 5/23/2023, with dates of service between 4/1/2023 and 5/23/2023. Refer to the corrected coding chart from L23-15 below:

 

Code	Required Modifier	Units	Rate	Note
A9274	KH	Initial Kit = 1 controller (free) +16 pods (one pod is a training pod)	$829.50	For initial use providers must append the KH modifier to A9274. Providers may not bill separately for the controller or the training pod.
A9274		15 per month (pods only)	$55.30 (per pod)	15 units = 15 pods

Wonder if they'd ever just give diabetics in need of help a funded HSA and let them price-shop for themselves?

Almost anything would be better than sending out so many notices, they need their own alphanumeric identification system.