Hospital Beds Targeted Probe and Educate Review Updates: January - March 2018

The Jurisdiction D, DME MAC, Medical Review Department is conducting a targeted probe and educate reviews of HCPCS code(s) E0250 and E0260.

Based on dollars, the overall claim potential improper payment rate is 34%.

Top Denial Reasons

  • Documentation was not received in response to the Additional Documentation Request (ADR) letter.
  • Documentation does not support coverage criteria for a semi-electric hospital bed.
  • Documentation does not support coverage criteria for a fixed height hospital bed.
  • Documentation does not support medical necessity.

For complete details, see the Hospital Beds Quarterly Results of Targeted Probe and Educate Review webpage.

            Last Updated Thu, 07 Jun 2018 10:41:21 +0000