The Jurisdiction A, DME MAC, Medical Review Department is conducting a Targeted Probe and Educate (TPE) review of HCPCS code(s) E0431 and E1390. The quarterly edit effectiveness results from April 2019 - June 2019 are as follows:

Based on dollars, the overall claim potential improper payment rate is 34%.

Top Denial Reason

• Documentation does not support coverage criteria

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