Glucose testing supplies have 99% error rate

Tuesday, April 21, 2015

YARMOUTH, Maine – National Government Services, the DME MAC for Jurisdiction B, conduced a widespread prepayment probe review of glucose testing supplies (A4253KX) between Oct. 22 and Jan. 1 and found all but one of 100 claims were denied. The top reasons for denials were: no medical records were submitted; the proof of delivery record did not include the beneficiary signature; the detailed written order did not include a physician signature that complied with CMS’s signature requirements; the proof of delivery record did not include the delivery address; no documentation to support the specific reason for additional materials; and refills of quantities of supplies that exceed the utilization guidelines were dispensed with no documentation within the past six months that the beneficiary is testing at a frequency that corroborates the quality of supplies that have been dispensed.