So, you have received a Medicare DME A6010 Audit. First, don’t worry. If they are requesting one chart at a time, this is not a full-blown audit. These are post-payment audits. Medicare goes through phases where they audit specific items for a period. It does NOT mean that you did anything wrong.
Respond. Do not ignore it! Submit the information in the time frame they are requesting.
Submit the following items:
- Standard Written Order* or prescribed in the SOAP note, which includes:
- Beneficiary name and date
- Name of the product (HELIX3-CP Collagen Powder 1-gram packets)
- How many 1-gram packets you are prescribing and dispensing.
- How often the patient is changing the dressing. Daily? Every 3 days etc.?
- Description of what the collagen is being used to treat. (Example: A full-thickness, right foot chronic ulcer.)
- Make sure that the Standard Written Order or the office note is signed by the physician!
- Copy of the chart note that includes the description of the surgery or debridement that was performed. Remember, these are surgical dressings. Some type of surgery (debridement is a surgery) must have been performed. The chart note must also state information on the ulcer and drainage. Make sure the note is dated and signed.
- Proof of Delivery*. Make sure that you have your address listed. Be specific about which product was dispensed and how much of it was dispensed. You should include the lot number located on the bottom of the collagen box. If you used AMERX’s Patient Direct Program, be sure to include a copy of the shipping proof of delivery form.
Medicare can audit one chart every 45 days and will continue to do so. Do not be discouraged if you receive another audit. These audits are quick and easy to pass if you submit the correct documentation in a timely matter.
*Standard Written Order and Proof of Delivery forms are available FREE to physicians in the AMERX network, included when you download the AMERX HCPCS Coding Guidance or call your Account Manager at (800) 448-9599 to request copies.