What Does It Mean to Have a PDAC Letter?
We are continually asked if a product has a “PDAC letter." What does this mean and which products require coding verification letters? Let’s start with a review of PDAC.
We are continually asked if a product has a “PDAC letter. “What does this mean and which products require coding verification letters? Let’s start with a review of PDAC.
PDAC is the pricing, coding analysis, and coding (PDAC), contractor to CMS.PDAC is responsible for (among other things) providing suppliers and manufacturers with assistance in determining which HCPCS code should be used to describe DMEPOS items for the purpose of billing Medicare. In addition, the PDAC publishes a product classification list on its website that lists individual items to code categories: www.dmepdac.com
The process starts when a manufacturer submits a product to PDAC for coding verification. The PDAC will review the submitted material and product. A coding decision letter is sent to the manufacturer once a final code is determined for the product. The product and assigned code are then listed on the PDAC website.
While coding verification by the PDAC is a voluntary process for most products, some require coding verification review prior to claims submission.Click here for a complete listing of products requiring PDAC coding verification.
What Does This Mean for You?
If a specific HCPCS code requires the product be reviewed by PDAC prior to claims submission, be sure to check the PDAC website to verify the product is listed with the code.
If PDAC coding verification is not required for a product or the manufacturer has not voluntarily submitted a product for coding verification, then the responsibility for coding decisions lies with the supplier.