Manual Wheelchair Bases Targeted Probe and Educate Review Updates: October-December 2018

The Jurisdiction A, DME MAC, Medical Review Department is conducting a Targeted Probe and Educate (TPE) review of HCPCS code(s) K0001 and K0003. The quarterly edit effectiveness results from October 2018 through December 2018 are as follows:

Based on dollars, the overall claim potential improper payment rate is 38%.

Top Denial Reasons

  • Documentation does not support coverage criteria.
  • Documentation was not received in response to the Additional Documentation Request (ADR) letter.

For complete detail see, Manual Wheelchair Bases Quarterly Results of Targeted Probe and Educate Review

 

Last Updated Mar 06, 2019