Tag: jurisdiction D DME MAC

FARGO, N.D. -A documentation compliance review for oxygen concentrators (E1390) from Sept. 1, 2014, to Nov. 30, 2014, resulted in an overall error rate of 21%, according to the Jurisdiction D DME MAC. The most common reasons for denial: proof of delivery (POD) was not submitted or was invalid; no documentation to support the beneficiary had been seen and evaluated by the treating physician within 30 days prior to the date of the initial Certificate of Medical Necessity (CMN); and no request documentation...

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...