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Elizabeth M. Whitehorn, Director

DME Oxygen Claims Overpaying

HFS System Issue:

Oxygen procedure codes should be reimbursed at a monthly flat rate. See Provider Notice dated September 27, 2012, Oxygen Reimbursement Changes Effective December 1, 2012.

Problem:

The system is multiplying the quantity billed by the monthly maximum amount resulting in overpayments.

Providers Impacted:

DME providers that dispense oxygen equipment and supplies.

Procedure Codes Impacted:

Oxygen contents: E0441, E0442, E0443, E0444, E1390

Problem Begin Date:

Claims Received for dates of service after 12/1/2012.

Problem Fix Date:

To be announced. Continue to monitor this page for system fix updates.

Resolution for Impacted Claims:

Claims that have been previously overpaid will be systematically adjusted by the department. Until the system changes are implemented, the department will continue to review the procedure codes billed and adjust overpayments. Providers should bill a quantity of one (1) to avoid overpayments.