Jurisdiction C Reviewing LSO Claims

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The medical review staff at CGS, the Jurisdiction C Durable Medical Equipment Medicare Administrative Contractor is conducting a complex post-pay, service-specific medical review of LSOs. The Healthcare Common Procedure Coding System codes under review are L-0457, L-0637, L-0650, and L-0648.

The review is being conducted because data analysis revealed that Jurisdiction C's allowed dollars for the codes were significantly above expected amounts. Additionally, the policy group for LSOs ranked sixth in Comprehensive Error Rate Testing (CERT) errors.