To help providers of positive airway pressure (PAP) therapy avoid improper payments and denials due to insufficient documentation, the Centers for Medicare and Medicaid Services (CMS) Medicare Learning Network (MLN) recently posted a fact sheet, “Provider compliance tips for PAP devices and accessories including continuous positive airway pressure (CPAP).”
According to CMS, the Medicare Fee-For-Service improper payment rate for CPAP was 59 percent with nearly $495 million in projected improper payments for the 2017 reporting period. Insufficient documentation accounted for 87.8 percent of improper payments for PAP devices and supplies. Additional types of errors for CPAP in the 2017 reporting period were no documentation (0.6 percent) and other (11.6 percent).
Additional guidance is available in a policy article previously published by CMS.