Hospital Beds 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) E0250 and E0260. The quarterly edit effectiveness results from April 2019 - June 2019 are as follows:

Based on dollars, the overall claim potential improper payment rate is 37%.

Top Denial Reasons

  • Documentation does not support coverage criteria for a semi-electric hospital bed
  • Documentation was not received in response to the Additional Documentation Request (ADR) letter
  • Documentation does not support coverage criteria for a fixed height hospital bed

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

            Last Updated Tue, 22 Oct 2019 12:48:03 +0000