Oxygen and Oxygen Equipment Targeted Probe and Educate Review Updates: April - June 2019

The Jurisdiction D, DME MAC, Medical Review Department is conducting a Targeted Probe and Educate (TPE) review of HCPCS code(s) E0424, E0431, E0434, E0439, and E1390. The quarterly edit effectiveness results from April 2019 - June 2019 are as follows:

Based on dollars, the overall claim potential improper payment rate is 32%.

Top Denial Reasons

  • Documentation does not support coverage criteria
  • Documentation was not received in response to the Additional Documentation Request (ADR) letter

For complete detail see, Oxygen Quarterly Results of Targeted Probe and Educate Review

            Last Updated Mon, 28 Oct 2019 16:01:28 +0000