Dr. Richie has advised us that there has been an increase in failure rates in random Medicare pre-payment audits in Region D for all custom AFO devices for codes L-1940 to L-1970. The below is the required documentation you will need.
1. All in One Medication Necessity Document
2. Copy of Noridian DME Justification D dated August 2013, pages 101-103.
3. Required documentation you will require if audited:
a. Prescription for the device
b. Chart notes which indicated the medical condition and reason an AFO is needed for the condition (diagnosis)
c. A document indicating the reason a Custom vs. Pre-Fab device is needed
d. Proof of service (receipt)
It is important to note that the audits are for pre-payments, no penalties or fines/punishments for providers, the claims were just denied.
If you need help or have questions, please contact us at 1-888-523-1600 or email us at firstname.lastname@example.org.
We will be sending all of our Richie Brace accounts a copy of the All in One Medication Necessity Document and the Copy of Noridian DME Justification D in the mail.