Article Detail - JD DME
Manual Wheelchair Targeted Probe and Educate Review Updates: October - December 2018
The Jurisdiction D, DME MAC, Medical Review Department is conducting a Targeted Probe and Educate (TPE) review of HCPCS code(s) K0001 and K0003. The quarterly edit effectiveness results from October – December 2018 are as follows:
Based on dollars, the overall claim potential improper payment rate is 29%.
Top Denial Reasons
- Documentation was not received in response to the Additional Documentation Request (ADR) letter.
- Documentation does not support coverage criteria for a lightweight wheelchair.
- Documentation does not support medical necessity.
For complete detail see, Manual Wheelchair Quarterly Results of Targeted Probe and Educate Review.
Last Updated Tue, 05 Mar 2019 10:24:38 +0000