Too Many K0823 Claims Denied

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.