Non-Medical Record Reviews - Noridian reviews used to determine the extent of potential problem areas across multiple DME product classifications and monitor corrective action measures implemented to reduce improper payments.
Diabetic Supplies
Review Criteria |
Current Error Rate |
Service Specific Review Notification |
Current Review Results |
A4253KS: BLOOD GLUCOSE TEST OR REAGENT STRIPS FOR HOME BLOOD GLUCOSE MONITOR, PER 50 STRIPS |
53% |
|
|
A4253KX: BLOOD GLUCOSE TEST OR REAGENT STRIPS FOR HOME BLOOD GLUCOSE MONITOR, PER 50 STRIPS |
56% |
|
|
External Infusion Pumps
Review Criteria |
Current Error Rate |
Service Specific Review Notification |
Current Review Results |
E0781: AMBULATORY INFUSION PUMP, SINGLE OR MULTIPLE CHANNELS, ELECTRIC OR BATTERY OPERATED, WITH ADMINISTRATIVE EQUIPMENT, WORN BY PATIENT |
35% |
|
|
E0784: EXTERNAL AMBULATORY INFUSION PUMP, INSULIN |
22% |
|
|
Immunosuppressive Drugs
Review Criteria |
Current Error Rate |
Service Specific Review Notification |
Current Review Results |
J7507: TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG |
23% |
|
|
J7517: MYCOPHENOLATE MOFETIL, ORAL, 250 MG |
50% |
|
|
J7518: MYCOPHENOLIC ACID, ORAL, 180 MG |
70% |
|
|
J7520: SIROLIMUS, ORAL, 1 MG |
23% |
|
|
Nebulizers
Review Criteria |
Current Error Rate |
Service Specific Review Notification |
Current Review Results |
J7605: ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS |
27% |
|
|
J7626: BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG |
31% |
|
|
Oxygen and Oxygen Equipment
Review Criteria |
Current Error Rate |
Service Specific Review Notification |
Current Review Results |
E1390: OXYGEN CONCENTRATOR, SINGLE DELIVERY PORT, CAPABLE OF DELIVERING 85 PERCENT OR GREATER OXYGEN CONCENTRATION AT THE PRESCRIBED FLOW RATE |
10% |
|
|