Article Detail - JD DME
Oxygen and Oxygen Equipment 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) E0424, E0431, E0434, E0439 and E1390. The quarterly edit effectiveness results from July - September 2018 are as follows:
Based on dollars, the overall claim potential improper payment rate is 45%.
Top Denial Reasons
- Documentation does not support coverage criteria
- Documentation was not received in response to the Additional Documentation Request (ADR) letter
- Documentation does not support a qualifying blood gas study
For complete detail see, Oxygen Quarterly Results of Targeted Probe and Educate Review.
Last Updated Mon, 31 Dec 2018 11:55:25 +0000