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 .