Positive Airway Pressure (PAP) Targeted Probe and Educate Review Updates: April - June 2018

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 2018 - June 2018 are as follows:

  • Based on dollars, the overall claim potential improper payment rate is 14%.

Top Denial Reasons

  • Documentation was not received in response to the Additional Documentation Request (ADR) letter.
  • Claim is a duplicate to a previously submitted claim.
  • Documentation does not support coverage criteria.

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

            Last Updated Tue, 11 Sep 2018 07:44:01 +0000