Oxygen and Oxygen Equipment Targeted Probe and Educate Review Updates: January - March 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 January - March 2019 are as follows:

Based on dollars, the overall claim potential improper payment rate is 38%.

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 Thu, 27 Jun 2019 10:18:08 +0000