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Noridian recently announced several service-specific, pre-payment reviews for suppliers billing to Jurisdiction D. Please see the list below to determine if the services you provide to beneficiaries in Jurisdiction D could be at risk for an audit. Recently added:

• TENS (E0730) – Potential improper payment rate of 98 percent.
• External infusion pumps (E0781, E0784) -- Potential improper payment rates of 37 percent and 61 percent (documentation compliance review).

Codes that will remain on pre-payment review due to recently published improper payment rates:

• Therapeutic shoes (A5500) - Improper payment rate of 76 percent.
• Oxygen (HCPCS E0439, E0434) - Improper payment rate of 55 and 37 percent, respectively.
• Hospital beds (HCPCS E0260) – Improper payment rate of 52 percent.
• Ankle-foot/knee-ankle-foot orthosis (HCPCS L1960, L1970, L4360, L4361) - Improper payment rate of 73, 78, 98 and 73 percent, respectively.
• Spinal orthoses (HCPCS L0648, L0650) - Improper payment rate of 99 and 98 percent, respectively.
• Knee orthoses (HCPCS L1832, L1833, L1843) - Improper payment rate of 67, 92 and 83 percent, respectively.
• Urological supplies (HCPCS A4351, A4353, A4358) - Improper payment rate of 50, 77 and 66 percent, respectively.

For complete details on these reviews, refer to the Noridian DME MAC Jurisdiction D website.