Positive Airway Pressure (PAP) Devices 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) E0601. The quarterly edit effectiveness results from July - September 2018 are as follows:
Based on dollars, the overall claim potential improper payment rate is 10%.
Top Denial Reasons
- Documentation was not received in response to the Additional Documentation Request (ADR) letter
- Documentation does not support coverage criteria
- Detailed Written Order (DWO) is incomplete or missing elements
For complete detail see, PAP Quarterly Results of Targeted Probe and Educate Review.
Last Updated Dec 31, 2018