National Webinar Addressing Insufficient Orthotic Documentation
Dave McGill
05-24-2023
Blog
On June 1st at 2 PM ET the DME CERT Outreach and Education Task Force is hosting a webinar to address error trends in and documentation requirements for lower limb bracing claims.
What You Need to Know:
Based on Comprehensive Error Rate Testing, lower limb orthoses have the 3rd highest error rate in the DMEPOS space. Specifically, the improper payment rate calculated by the CERT contractor was 57.5%, which projects to improper payments of just under $188M per year. The CERT contractor identified the following as the top 5 errors:
- Base item denial leading to add-on denial;
- Inadequate/missing documentation to support coverage criteria;
- Inadequate/missing description of modification to the orthosis at the time of fitting;
- Inadequate/missing proof of delivery;
- Missing order.
What This Means for You:
If Medicare continues to see error rates this high for orthotic claims, it is likely to expand auditing activities. Getting claims right the first time is a critically important way you can (a) survive audits successfully and (b) avoid them altogether. We encourage all R&R subscribers to attend this national webinar. You can register for the event by clicking here.