MedicaidAdministrativeMedium impact
Reminder to Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Unit Requirement for Wearable Cardioverter Defibrillator (WCD) Vests Before Receiving Replacement Supplies
Nevada Medicaid·NV · Cardiology·Provider Enrollment
Effective date
Jan 21, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid now requires 10 paid units of K0606 (WCD vest) across 10 months before allowing billing of replacement supplies (batteries, garments, electrodes). Claims for supplies without this prerequisite will deny with error code 6516.
Action Required
Immediately: DME billing team must verify 10 paid K0606 claims exist for each recipient before billing K0607, K0608, or K0609 replacement supplies. Update billing system to check this prerequisite. Claims will deny with error code 6516 if billed prematurely.