Mobility

Too Many K0823 Claims Denied

An NHIC review of 1,000 K0823 power wheelchair claims paid in the second quarter showed providers still aren't getting them right

HINGHAM, Mass. — An NHIC review of 1,000 K0823 power
wheelchair claims paid in the second quarter showed providers still
aren't getting them right, the Jurisdiction A DME MAC said last
week. Submitted by 394 different suppliers, only 237 of the claims
were allowed while 763 were denied. Based on the documentation
received, NHIC said 78.9 percent of the claims had incomplete
documentation and 16 percent were determined to be medically
unnecessary. As a result, the DME MAC said it would continue to
review the Group 2 PWC claims.



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