NHIC Corp., the Jurisdiction A DME MAC has released the latest results from its ongoing documentation compliance review (DCR) for power mobility devices in the K0823 HCPCS code.
The results are from third-quarter claims processed from July 1 through Sept. 30, 2014.
During that time, NHIC reviewed 337 claims, including reopenings, according to a March 19 news announcement. Of that total, 43 claims were denied, creating a claim denial rate of 13 percent.
Common reasons for denials, NHIC said, included missing physician signatures on face-to-face assessment documentation, incomplete or missing home assessments, and delivery dates that didn’t match dates of service.
DCRs, NHIC said, are “non-clinical, technical reviews that evaluate the presence or absence of particular pieces of required documentation necessary for payment according to the Local Coverage Determination for that DMEPOS item.” The review of Group 2 power wheelchairs in the K0823 code, the DME MAC indicated, was due to “a high volume of claim errors found by the Comprehensive Error Rate Testing (CERT) contractor.”
