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Tag: Jurisdiction B


News

CGS gains lion's share of DME workload

January 13, 2016HME News Staff

NASHVILLE - CMS has awarded CGS Administrators a $78 million contract for DMEPOS claims in Jurisdiction B, according to a press release.The contract represents approximately 20.7% of the national DMEPOS workload and covers claims by more than 6.8 million beneficiaries and 18,000 DME suppliers in Kentucky, Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin.Nationally, CGS will now administer about 60% of Medicare DME claims.CGS, which has been headquartered here since 1966 and employs more...

CGS Administrators, Jurisdiction B


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Jurisdiction B reviews for power wheelchairs and catheters

December 5, 2014HME News Staff

INDIANAPOLIS -A claim review of power wheelchair-related options and accessories (K0820-K0829) from July 1, 2014, to Sept. 30, 2014, showed a denial rate of 81%. In the previous quarter, the rate was 84%. The most common reasons for denial:The face-to-face examination did not support why a manual wheelchair or a power operated vehicle wouldn't meet the beneficiary's mobility needs in the home; face-to-face examination did not support the beneficiary's mobility limitation…Also under claim review arecatheters...

Jurisdiction B


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Jurisdiction B releases review results for support surfaces, CPAP devices

August 22, 2014HME News Staff

YARMOUTH, Maine - Group 2 pressure reducing support surfaces had a claims error rate of 73.7% from April 1, 2014, to June 30, 2014, the Jurisdiction B DME MAC has reported. Top denial reasons included insufficient documentation of larger or multiple stage III or stage IV pressure ulcers on trunk or pelvis that have not improved over the last month, and insufficient documentation due to a missing signature. CPAP devices had a claims error rate of 67% for the same timeframe, the MAC reported. Top denial...

CPAP Devices, Jurisdiction B, review, support surfaces


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