Error rate for glucose test strips tops out

Thursday, May 15, 2014

INDIANAPOLIS - A prepayment review of glucose test strips resulted in a claim error rate of 99.2%, according to National Government Services. The Jurisdiction B DME MAC reviewed 8,758 claims filed between Jan. 1 and March 31. The top four reasons for denial: lack of medical necessity, documentation not returned within the requested time frame, billing more than the standard allowed quantity, and incorrect modifier submitted. Claims denied due to lack of medically necessary were: missing progress notes, proof that the testing frequency was medically necessary or the quantity of supplies remaining for the refill requests; were already billed or paid to the same or a different supplier or same or similar dates of service; were billed with the KS modifier instead of the KX modifier to indicate the beneficiary used insulin; included a written order without the quantity to be dispensed; or included a proof of delivery record that lacked sufficiently detailed descriptions to identify the items delivered.