Enteral Nutrition Targeted Probe and Educate Review Updates: April-June 2019

The Jurisdiction A, DME MAC, Medical Review Department is conducting a Targeted Probe and Educate (TPE) review of HCPCS code(s) B4150, B4152, and B4154. The quarterly edit effectiveness results from April 2019 - June 2019 are as follows:

Based on dollars, the overall claim potential improper payment rate is 12%.

Top Denial Reasons

  • Documentation does not support coverage criteria
  • The time limit for filing a claim expired

For complete detail see, Enteral Quarterly Results of Targeted Probe and Educate Review

            Last Updated Tue, 22 Oct 2019 12:49:30 +0000