First Quarter Edit Effectiveness for Therapeutic Shoes Review
The Jurisdiction D DME MAC Medical Review Department is conducting a widespread complex review of HCPCS codes A5500. The first quarter edit effectiveness results from September 2011 through December 2011 are as follows:
This review identified 214 claims of which 207 were denied. A total of 42 claims were denied for no response to the additional documentation request. This resulted in an overall error rate of 97%. Due to this high error rate, NAS will continue with the widespread complex review. Click here to view the complete story.