Some DME claims incorrectly denied 8/7-8/30

We found a processing error that was causing inappropriate denials for some durable medical equipment (DME) codes under a medically unlikely edit (MUE). Claims were affected by this error from Aug. 7 until it was fixed on Aug. 30.

Claims that were incorrectly denied and are currently being reprocessed. These claims may deny after being reprocessed if the units billed exceed the maximum frequency allowed.

Claim types affected

Professional Medicare DME claims with codes A4253 and A4259

Professional Medicaid DME claims with codes A4357, A4358, A4331, and B4087