CGS, the Durable Medical Equipment Medicare Administrative Contractor for Jurisdiction B and Jurisdiction C, announced that its medical review staff will be conducting a complex post-pay service-specific medical review of Healthcare Common Procedure Coding System (HCPCS) codes A-5500 and A5512-A5514 (Therapeutic Shoes/Inserts for Diabetics) claims.
The review is being conducted because data analysis revealed that Jurisdiction B’s allowed dollars for these HCPCS codes were significantly above expected amounts. Additionally, this policy group ranked eighth in total Comprehensive Error Rate Testing errors.