Article Detail - JA DME
Positive Airway Pressure (PAP) Targeted Probe and Educate Review Updates: July - September 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 July - September 2018 are as follows:
Based on dollars, the overall claim potential improper payment rate is 16%.
Top Denial Reasons
- Detailed Written Order (DWO) is incomplete or missing elements.
- Medical record documentation was not authenticated (handwritten or electronic) by the author.
- Documentation was not received in response to the Additional Documentation Request (ADR) letter.
- Documentation does not support coverage criteria.
For complete detail see, Positive Airway Pressure (PAP) Devices Quarterly Results of Targeted Probe and Educate Review.
Last Updated Thu, 20 Dec 2018 16:43:47 +0000