TriCenturion, the durable medical equipment program safety contractor for Jurisdiction B has announced what it described as a widespread compliance probe of Group 2 power wheelchairs (HCPCS K0823) for Jurisdictions A and B, announced at AAHomecare’s Rehab and Assistive Technology Council meeting held last week.
In a statement released, TriCenturion said, “Data analysis was completed for dates of service Dec. 1, 2006 through March 31, 2007 on new power chair codes that went into effect Nov. 15 2006. The allowed amount for Group 2 power wheelchairs accounts for more than 90 percent of the total allowed amount for all new power wheelchaird codes in each jurisdiction. More specifically the allowed amount for K0823 accounts for more than 77 percent of the allowed amount for Group 2 power wheelchairs in each jurisdiction.
According to the TriCenturion bulletin, “providers whose claims are selected for review will receive an Additional Documentation Request (ADR) letter asking for specific information to determine if the item billed complies with the existing reasonable and necessary criteria. Failure to supply the requested information within 30 days of the request will result in denial of the claim.”
For the complete bulletin, visit www.tricenturion.com.