Checklist: Home health referrals
Medicare home health referrals must contain information in the medical record from the certifying physician and/or acute/post...
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Prior authorization program for certain hospital outpatient department services
CMS implemented a prior authorization program for certain hospital outpatient department services for dates of service on or...
Paperwork (PWK)
Learn how PWK, the paperwork segment of the X12N version 5010, allows providers to submit medical documentation with their...
Checklist: Surgical services - nail cutting/paring and debridement
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation...
Targeted probe and educate (TPE) round results: Wound debridement (CPT 11042-11045)
Review the top denial/partial denial reasons and high-level results of wound debridement (CPT 11042-11045) TPE round results for...
Targeted probe and educate (TPE) round results: Rehabilitation services outpatient
View these round results for rehabilitation services outpatient.
Targeted probe and educate (TPE) round results: End stage renal disease (ESRD) (CPT 90960)
View targeted probe and educate (TPE) round results for end stage renal disease (ESRD).
Targeted probe and educate (TPE) round results: Psychotherapy services (CPT 90832, 90834, 90837)
View TPE round results for psychotherapy services.
Targeted probe and educate (TPE) round results: Evaluation and management services – initial inpatient care visits and subsequent inpatient care visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services - initial inpatient...
Targeted probe and educate (TPE) round results: Rehabilitation services outpatient (KX modifier)
View TPE round results for rehabilitation services outpatient (KX modifier).