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Procedure Coding System (HCPCS), adopted by reference in 7 AAC 160.900, and incontinence supplies assigned a “T” code must be billed with the respective specific manufacturer product code dispensed and the correct corresponding HCPCS code and modifier as set out on the Alaska Medicaid DMEPOS Fee Schedule, Tables I-5 through I-9, adopted by reference in 7 AAC 160.900, to be eligible for payment. Enteral product and incontinence supply reimbursement will be consistent with this section and are not eligible for higher allowable adjustment requests. (n) Providers may use the department’s price research form to request formal research of a state-based specific price established by the department that has not been established by CMS using the Alaska Medicaid DMEPOS Price Research Form. (o) An unaltered final purchase invoice is considered altered if

(1) information on the original invoice is removed, erased, redacted, omitted, or otherwise modified so that the copy submitted to the department is anything other than an exact copy of the original invoice received by the enrolled provider from the provider’s supplier; legible markings made by an enrolled provider on the original invoice as part of the enrolled provider’s normal business practices will not result in the department viewing an invoice as altered if the markings

(A) do not remove, erase, redact, omit, or otherwise modify the invoice in a way that results in any of the information on the original invoice becoming illegible; and

(B) appear on both the original invoice and the copy submitted to the department; or

(2) the invoice shows a price other than the final price paid by the enrolled provider. (p) The Alaska Medicaid DMEPOS Fee Schedule, Tables I-5 through I-9, adopted by reference in 7 AAC 160.900, will be available quarterly in accordance with published CMS Medicare DMEPOS fee schedules. (q) In this section,

(1) “out-of-state” means that the provider is physically located in a state other than this state;

(2) “in-state” means that the provider is physically located in this state. (Eff. 2/1/2010, Register 193; am 7/7/2010, Register 195; am 6/2/2019, Register 230) Statutory Authority: Authority: AS 47.05.010 AS 47.07.030 AS 47.07.040