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| CO-96 Oxygen Claim Denials National Government Services, the Jurisdiction B Durable Medical Equipment Medicare Administrative Contractor (DME MAC) conducted analysis of oxygen claims denied during the first quarter of 2009 (January - March). The most common errors were claims which were submitted with the intention of beginning a new 36 month rental period because the reasonable useful lifetime of the previous equipment had been met. Below are examples of the most common errors: Claims did not include a new initial Certificate of Medical Necessity (CMN)Claims did not include the RA modifier indicating the oxygen equipment billed is a replacementClaims did not include required information in the NTE segment of the claim to indicate that it was a reasonable useful lifetime replacement.Claims for subsequent months were billed prior to the new initial CMN being set up in the DME MAC claim payment system The claims were denied with ANSI code CO-96 with a remittance advice remark code of N370, which indicates the charge is denied as non-covered because the billing exceeds rental months covered/approved by the payer. The beneficiary cannot be held liable for the denied charges. To view this article in its entirety please click on or copy and paste the following link into your internet browser:http://www.ngsmedicare.com/NGSMedicare/DMEMAC/EducationandSupport/ToolsandMaterials/CO_96.aspx |
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