Oxygen 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) E0431 and E1390. 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 56%.

Top Denial Reasons

  • Documentation does not support coverage criteria.
  • Documentation does not support a qualifying blood gas study.

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

Last Updated Mar 05, 2019