DME MAC (Durable Medical Equipment Medicare Administrative Contractor) for Jurisdiction A is initiating a documentation compliance repayment review of claims for oxygen and oxygen equipment. The review is in response to a high volume of claim errors identified by the Comprehensive Error Rate Testing (CERT) Contractor for missing and/or incomplete documentation.
Oxygen suppliers will be sent a documentation request for the following information:
- The detailed written order
- Certificate of Medical Necessity (CMN)
- Copy of the laboratory result for the arterial blood gas PO2 and/or oxygen saturation test value reported on the CMN
- Documentation of physician office visit prior to the initial date of service
- Proof of delivery.
The requested information must be returned within 30 days from the date of the letter to avoid claim denials.