Positive Airway Pressure (PAP) Devices 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) E0601. The quarterly edit effectiveness results from April 2019 - June 2019 are as follows:

Based on dollars, the overall claim potential improper payment rate is 13%.

Top Denial Reasons

  • Detailed Written Order (DWO) was not received
  • Related Item Denied: Unbundling
  • Written Order Prior to Delivery (WOPD) is incomplete or missing elements

For complete detail see, Positive Airway Pressure (PAP) Devices Quarterly Results of Targeted Probe and Educate Review

            Last Updated Tue, 22 Oct 2019 12:54:59 +0000