Jurisdiction D Reports Results of Widespread Pre-Payment Review for Spinal Orthoses


Noridian Healthcare Services, the Jurisdiction D DME MAC contractor has released the results from pre-payment reviews of claims for spinal; orthoses described by codes L0631 and L0637.  For claims reviewed during the first quarter of 3013, the error rate for L0631 was 83% and the error rate for L0637 was 82%.  In both cases, approximately 15% of denials were the result of an incomplete or missing proof of delivery document.

As a result of the high error rate, Jurisdiction D claims for both L0631 and L0637 will remain under widespread pre-payment review.

The full report may be found on the Jurisdiction D website.

Questions regarding this issue may be directed to Joe McTernan at  or Devon Bernard .