Medical Review Quarterly Reports
Quarterly TPE Exclusion Rates:
Supplier results for all TPE reviews completed April 2023 - June 2023:
- 10 Claim Pilot – 4% Successfully Passed
- Round 1 – 49% Successfully Achieved Exclusion
- Round 2 – 45% Successfully Achieved Exclusion
- Round 3 – 35% Successfully Achieved Exclusion
Description | HCPCS |
---|---|
Ankle-Foot Orthoses (AFO) | L1902, L1906, L1932, L1971, L2114, L4360, L4361, L4386, L4387, L4396, and L4397 |
Blood Glucose Test Strips | A4253 |
Commodes | E0163 and E0165 |
Enteral Nutrition | B4035 |
Hospital Beds | E0260, E0261, and E0303 |
Immunosuppressive Drugs | J7503, J7507, J7518, J7520, and J7527 |
Knee Orthoses | L1832, L1833, L1843, L1844, L1845, L1851, L1852, and L2397 |
Manual Wheelchairs | K0001-K0004 |
Spinal Orthoses | L0450-L0651 |
Surgical Dressings | A6010, A6021, A6196-A6199, A6203, A6209-A6212, A6231-A6233, A6234-A6241, A6242-A6248, and A6251-A6256 |
Therapeutic Shoes for Persons with Diabetes (TSPD) | A5500, A5512, and A5513 |
Urological Supplies | A4316, A4351, A4352, A4353, and A4355 |
Updated: 08.11.23