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First Quarter Edit Effectiveness for Therapeutic Shoes Review

Tuesday, March 13, 2012   (0 Comments)
Posted by: Brian Lagana
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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.


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