‘Lessons Learned’ from E0601 Claims Review
In a recent widespread probe review of post-payment claims for CPAP devices, the Jurisdiction C DME MAC said the review “showed that suppliers are not following published Medicare guidelines and policies
NASHVILLE, Tenn. — In a recent widespread probe review of post-payment claims for CPAP devices, the Jurisdiction C DME MAC (Cigna) said the review “showed that suppliers are not following published Medicare guidelines and policies in submitting claims for necessary and reasonable HCPCS code E0601 services.” The calculated error rate (determined by dividing the dollar amount of services paid in error by the dollar amount of services medically reviewed) was 63.94 percent. See “lessons learned” from the review on the Jurisdiction C website.
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