The widespread prepay probe reviews of claims includes K0001 (standard wheelchair), K0003 (lightweight wheelchair) and K0004 (high strength lightweight wheelchair).
Monday, May 9, 2011

FARGO, N.D. — Noridian Administrative Services announced May 5 it would begin widespread prepay probe reviews of claims for HCPCS codes K0001 (standard wheelchair), K0003 (lightweight wheelchair) and K0004 (high strength lightweight wheelchair) based on the results of CERT analysis. All suppliers billing Jurisdiction D for the HCPCS codes are subject to the review, the DME MAC said.

Suppliers of the selected claims will receive an Additional Documentation Request (ADR) letter asking for specific information. Failure to supply the information within 30 days of the date on the letter will result in the claim being denied as not medically necessary, Noridian said.

See the notice in full.