| Service Type Billed to DMERCs (SADMERC Policy Group) |
Paid Claims Error Rate |
95% Confidence Interval |
Type of Error |
| No Documentation |
Insufficient Documentation |
Medically Unnecessary Services |
Incorrect Coding |
Other |
/
|
/
|
/
|
/
|
/
|
/
|
/
|
/
|
| Surgical Dressings |
75.7% |
52.3% - 99.1% |
99.0% |
0.0% |
1.0% |
0.0% |
0.0% |
| Support Surfaces |
29.6% |
3.1% - 56.1% |
99.7% |
0.0% |
0.3% |
0.0% |
0.0% |
| Urological Supplies |
19.5% |
2.1% - 36.8% |
87.2% |
5.7% |
7.2% |
0.0% |
0.0% |
| Ostomy Supplies |
16.2% |
1.2% - 31.2% |
54.0% |
13.1% |
28.9% |
1.3% |
2.7% |
| Glucose Monitor |
13.6% |
11.5% - 15.8% |
3.6% |
2.6% |
86.9% |
6.9% |
0.0% |
| Lower Limb Orthoses |
9.8% |
( 0.1%) - 19.7% |
41.9% |
0.0% |
55.9% |
2.2% |
0.0% |
| CPAP |
7.4% |
2.4% - 12.3% |
34.8% |
2.8% |
60.7% |
1.7% |
0.0% |
| Diabetic Shoes |
7.2% |
0.2% - 14.3% |
12.7% |
31.1% |
56.3% |
0.0% |
0.0% |
| All Policy Groups with Less than 30 Claims |
6.8% |
1.2% - 12.5% |
33.1% |
5.9% |
60.2% |
0.8% |
0.0% |
| Nebulizers & Related Drugs |
6.0% |
1.8% - 10.2% |
4.2% |
11.3% |
55.3% |
24.6% |
4.6% |
| Patient Lift |
5.9% |
( 1.1%) - 12.8% |
0.0% |
51.8% |
48.2% |
0.0% |
0.0% |
| Wheelchairs Options/Accessories |
5.9% |
0.2% - 11.5% |
0.0% |
1.9% |
96.6% |
0.6% |
0.9% |
| Immunosuppressive Drugs |
4.9% |
( 0.0%) - 9.8% |
42.8% |
22.1% |
31.5% |
3.6% |
0.0% |
| Respiratory Assist Device |
3.5% |
( 1.8%) - 8.9% |
70.1% |
0.0% |
29.9% |
0.0% |
0.0% |
| Wheelchairs Manual |
2.5% |
1.0% - 4.0% |
0.0% |
21.6% |
51.8% |
17.4% |
9.3% |
| Walkers |
2.5% |
0.2% - 4.8% |
33.7% |
0.0% |
66.3% |
0.0% |
0.0% |
| Lenses |
2.4% |
( 0.4%) - 5.2% |
0.0% |
13.2% |
86.8% |
0.0% |
0.0% |
| Enteral Nutrition |
1.7% |
0.0% - 3.3% |
59.4% |
0.0% |
0.7% |
40.0% |
0.0% |
| Hospital Beds/Accessories |
1.1% |
( 0.2%) - 2.4% |
0.0% |
55.6% |
36.0% |
0.0% |
8.4% |
| All Other Codes |
0.8% |
0.1% - 1.6% |
22.2% |
22.7% |
46.0% |
9.1% |
0.0% |
| Oxygen Supplies/Equipment |
0.7% |
0.2% - 1.1% |
5.5% |
11.1% |
63.0% |
4.1% |
16.3% |
| All Types of Services |
7.5% |
4.8% - 10.2% |
44.3% |
5.1% |
45.0% |
4.7% |
0.9% |