The medical director for Jurisdiction C, Dr. Robert Hoover, announced the DME MACs will exclude respiratory, infusion, and CGM claims when Targeted Probe and Educate (TPE) prepayment reviews resume.
In a Medicare Minute video posted last month, Dr. Hoover explained the initial phase of TPE reviews will not include claims with dates of service after March 1, 2020, for those items covered by COVID-19 clinical indication waivers.
Once the prepayment TPE reviews begin, we suspect the following products, currently subject to post-payment audits, will be the first to migrate:
SOURCE LINKS
https://cgsmedicare.com/jc/education/video/mm_tpe_transcript_2021.pdf
https://cgsmedicare.com/jc/education/video/vid_tper.html
In a Medicare Minute video posted last month, Dr. Hoover explained the initial phase of TPE reviews will not include claims with dates of service after March 1, 2020, for those items covered by COVID-19 clinical indication waivers.
Once the prepayment TPE reviews begin, we suspect the following products, currently subject to post-payment audits, will be the first to migrate:
- Ankle foot orthotics (AFOs).
- Back braces.
- Diabetic testing supplies.
- Knee braces.
- Ostomy.
- Surgical dressings.
- Urological supplies.
- Therapeutic shoes.
SOURCE LINKS
https://cgsmedicare.com/jc/education/video/mm_tpe_transcript_2021.pdf
https://cgsmedicare.com/jc/education/video/vid_tper.html
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