DME MAC (Durable Medical Equipment Medicare Administrative Contractor) for Jurisdiction A is initiating a documentation compliance repayment review of claims for oxygen and oxygen equipment. The review is in response to a high volume of claim errors identified by the Comprehensive Error Rate Testing (CERT) Contractor for missing and/or incomplete documentation.

Oxygen suppliers will be sent a documentation request for the following information:

  1. The detailed written order
  2. Certificate of Medical Necessity (CMN)
  3. Copy of the laboratory result for the arterial blood gas PO2 and/or oxygen saturation test value reported on the CMN
  4. Documentation of physician office visit prior to the initial date of service
  5. Proof of delivery.

The requested information must be returned within 30 days from the date of the letter to avoid claim denials.