Hospital Beds (HCPCS E0250, E0260) Quarterly Results of Targeted Probe and Educate Review

The Jurisdiction D, DME MAC, Medical Review Department is conducting a targeted probe and educate reviews of HCPCS code(s) E0250 and E0260. The quarterly edit effectiveness results from October 2017 through December 2017 are as follows:

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

Top Denial Reasons

  • Documentation does not support coverage criteria for a fixed height hospital bed.
  • Advance Beneficiary Notice of Noncoverage (ABN) was not properly executed.
  • Documentation does not support coverage criteria for a semi-electric hospital bed.
  • Written Order Prior to Delivery (WOPD) is incomplete or missing elements.

For complete detail see, Hospital Beds (HCPCS E0250, E0260) Quarterly Results of Targeted Probe and Educate Review.

Last Updated May 02, 2018