Article Detail - JA DME
Ankle-Foot Orthosis Targeted Probe and Educate Review Updates: July - September 2018
The Jurisdiction A, DME MAC, Medical Review Department is conducting a Targeted Probe and Educate (TPE) review of HCPCS code(s) L1970, L4360 and L4361. The quarterly edit effectiveness results from July - September 2018 are as follows:
Based on dollars, the overall claim potential improper payment rate is 39%.
Top Denial Reasons
- Documentation was not received in response to the Additional Documentation Request (ADR) letter
- Documentation does not support coverage criteria
For complete detail see, Ankle Foot Orthosis Quarterly Results of Targeted Probe and Educate Review.
Last Updated Mon, 31 Dec 2018 13:41:44 +0000