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prepay review

Coming soon: Prepay reviews for tilt and tilt and recline


NASHVILLE, Tenn. –The Jurisdiction C DME MAC has announced widespread prepayment reviews for power tilt (E1002) and power tilt and recline (E1007) wheelchairs.

Jurisdiction C DME MAC releases results of prepay reviews


A claim review of the initial month of therapy for CPAP devices (E0601) for Oct. 1, 2013, to Dec. 31, 2013, showed a denial rate of 48%.

MAC publishes prepay reviews for support surfaces, glucose monitors


INDIANAPOLIS – The claim error rate for Group 2 pressure reducing support surfaces (E0277) was 74% between July 1, 2013, and Sept. 31, 2013, according to a prepay review by National Government Services (NGS), the DME MAC for Jurisdiction B.

No stop to prepay review for certain power wheelchairs


INDIANAPOLIS – National Government Services (NGS), the DME MAC for Jurisdiction B, has reported a claims error rate for power wheelchair bases with options and accessories of 64% between April 1, 2013, and June 30, 2013.

New rule also impacts prepay review process


Most of the guidelines for prepayment medical review are found in manual guidance issued by CMS.

In brief: Face-to-face rule, IR meeting, PWC prepay review


BALTIMORE – CMS issued a proposed rule this week that details its plans to require a face-to-face evaluation within 90 days of a written order for certain high-cost durable medical equipment.