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CGS Administrators, LLC

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November 5, 2009

CERT Errors - Oxygen

The Comprehensive Error Rate Testing (CERT) contractor has been identifying a significant number of errors on claims for oxygen equipment. Most of the errors are due to insufficient documentation to support the medical necessity for the billed items. Based on reports received by the DME MACs, the documentation that the CERT contractor is looking for includes:

When suppliers receive a request from the CERT contractor on an oxygen claim, it is important to assure that all of these documents are included in the response. Suppliers should review the entire Oxygen policy for additional information at http://www.cgsmedicare.com/jc/coverage/lcdinfo.html. If any of these documents is not provided, it will likely result in a request for overpayment on the claim.

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