Reviews underway for oxygen, neb meds

Tuesday, October 22, 2013

FARGO, N.D. – Noridian, the Jurisdiction D DME MAC is conducting prepayment reviews of oxygen and oxygen equipment claims, and compliance reviews of neb-med claims. For the period July 2013 through October 2013, Noridian found a potential improper payment rate of 65% on E0439 claims, and a potential improper payment rate of 69% on E0434 claims. In both cases, most denials were because physician signatures were dated after the date of service, or a verbal/dispensing order was not provided. Noridian examined nebulizer medication claims filed between July 1, 2013 and Sept. 31, 2013, finding an overall error rate of 28%, mostly because Noridian did not receive documentation in time.