Completed Projects
When a project is completed, Noridian will forward the identified improper payments to CMS. CMS will direct the appropriate Medicare Administrative Contractor (MAC) to initiate the claim adjustments and/or overpayment recoupment actions.
Access completed projects below.
| Project Number | Project Title | Error Rate |
|---|---|---|
| 01-002 | Kwashiorkor | 4% |
| 01-003 | Hospital Outpatient Dental Services | 91% |
| 01-004 | Specimen Validity | 78% |
| 01-005 | Spinal Fusion | 25% |
| 01-006 | Inpatient Bone Marrow and Stem Cell Transplant Procedures | 86% |
| 01-008 | Electrodiagnostic Testing | 58% |
| 01-009 | General Inpatient Hospice | 36% |
| 01-010 | PAP Replacement Supplies and Accessories | 68% |
| 01-012 | Emergency Ambulance | 98% |
| 01-013 | Hospice Portfolio | 38% |
| 01-015 | Non-Emergency Ambulance | 79% |
| 01-019 | Spinal Cord Stimulator | 36% |
| 01-020 | Outpatient Hyperbaric Oxygen (HBO) | 38% |
| 01-021 | No Response Provider DME-DTS | 86% |
| 01-022 | Emergency Ambulance | 92% |
| 01-024 | Polysomnography | 46% |
| 01-025 | Inpatient Rehabilitation Facility (IRF) | 33% |
| 01-026 | Skilled Nursing Facility (SNF) | 17% |
| 01-027 | Specimen Validity Part 2 | 42% |
| 01-028 | Therapeutic Shoes for Diabetics | 70% |
| 01-029 | Intravenous Immune Globulin (IVIG) | 56% |
| 01-030 | Botulinum Toxins | 66% |
| 01-031 | DRG Thyroid, Parathyroid and Thyroglossal Procedures | 12% |
| 01-032 | TENS | 77% |
| 01-034 | Transforaminal Epidural Injection Phase I and Phase II | 65% |
| 01-036 | Hospice Portfolio – Phase 2 | 29% |
| 01-036 | Hospice Portfolio – Phase 3 | 47% |
| 01-038 | Facility Chronic Care Management (CCM) | 99% |
| 01-043 | DRG COVID 20% Add On Payment | 1% |
| 01-044 | BBA Therapy Reviews | 31% |
| 01-045 | Malnutrition | 53% |
| 01-046 | Inpatient Rehabilitation Facility Stays (IRF) Longer Length of Stay (LOS) | 54% |
| 01-047 | Electrodiagnostic Testing Axial Muscles and Spinal Levels | 48% |
| 01-049 | Vitamin D Testing | 96% |
| 01-050 | Podiatry | 45% |
| 01-054 | Carotid Artery Screening | 75% |
| 01-055 | Audio Only Telehealth Services During the PHE | 60% |
| 01-056 | SNF 3-Day Stay Waiver PHE | 36% |
| 01-057 | Potentially Unnecessary Surgeries | 48% |
| 01-058 | Traditional Telehealth | 88% |
| 01-060 | E&M No Response Providers DME Part II | 59% |
| 01-062 | EDX Diabetes | 56% |
| 01-065 | Total Joint Arthroplasty | 20% |
| 01-066 | Schizophrenia in SNF | 20% |
| 01-067 | Echocardiography | 47% |
| 01-069 | Treatment of Chronic Venous Insufficiency | 61% |
| 01-071 | E&M Dermatology Services | 48% |
| 01-072 | Neurostimulator Implantation | 53% |
| 01-079 | Dental Bone Grafting | 100% |
| 01-080 | Vitamin B12 with Modifier 25 | 43% |
| 01-081 | Unspecified Outpatient Dental Services CPT 41899 | 95% |
| 01-083 | HBO for LE Diabetic Wounds | 92% |
| 01-084 | Hospice General Inpatient (GIP) Level of Care | 79% |
| 01-085 | IRF | 37% |
| 01-086 | Home Health PDGM | 66% |
| 01-087 | OIG Facet Joint Denervation | 87% |
| 01-088 | SNF PDPM | 19% |
| 01-092 | Cryosurgery of the Prostate | 65% |
| 01-093 | Overlapping Claims – Hospital Transfers During the PHE | 12% |
| 01-095 | Mohs Surgery | 19% |
| 01-099 | Hospice 90 Day Stay | 11% |
| 01-301 | Home Health | 62% |
| 01-302 | Cataract Surgery | 51% |
| 01-303 | Surgical Dressings | 91% |
| 01-304 | Facet Joint Injections | 92% |
| 01-305 | Inpatient Psychiatric Facilities | 26% |
| 01-306 | Ostomy Supplies | 68% |
| 01-307 | Orthopedic Footwear | 69% |
| 01-308 | Outpatient Therapy | 39% |
| 01-309 | Ophthalmology Injections | 29% |
| 01-310 | Endomyocardial Biopsy with Right Heart Catheterization | 60% |
Option for Response – Appeal May be Available
Unless an overpayment demand letter has been sent to the provider/supplier from their respective MAC, an appeal request cannot be submitted.
Since SMRC does not handle appeal requests, requestors must address any overpayment recovery process or appeal rights with their MAC.
Last Updated Mar 22, 2024