Article Detail - JD DME
Immunosuppressive Drugs Targeted Probe and Educate Review Updates: July - September 2018
The Jurisdiction D, DME MAC, Medical Review Department is conducting a Targeted Probe and Educate (TPE) review of HCPCS code(s) J7507, J7517, J7518 and J7520. The quarterly edit effectiveness results from July - September 2018 are as follows:
Based on dollars, the overall claim potential improper payment rate is 39%.
Top Denial Reasons
- Documentation was not received in response to the Additional Documentation Request (ADR) letter
- Refill request documentation is incomplete or missing elements
- The date of service for item(s) billed has been paid
- Detailed Written Order (DWO) is incomplete or missing elements
For complete detail see, Immunosuppressive Drugs Quarterly Results of Targeted Probe and Educate Review.
Last Updated Mon, 31 Dec 2018 10:49:25 +0000