Medical review

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Targeted probe and educate (TPE) round results: End stage renal disease (ESRD) (CPT 90999)

Review the top denial / partial denial reasons and high-level results listed below from each round of JN ESRD TPE reviews.

Targeted probe and educate (TPE) round results: End stage renal disease (ESRD) (CPT 90999)

Review the top denial / partial denial reasons and high-level results listed below from each round of JN ESRD TPE reviews.

Targeted probe and educate (TPE) round results: Rehabilitation services outpatient (KX modifier)

View TPE round results for rehabilitation services outpatient (KX modifier).

Targeted probe and educate (TPE) round results: Rehabilitation services outpatient (KX modifier)

View TPE round results for rehabilitation services outpatient (KX modifier).

2025 jurisdiction list for DMEPOS HCPCS codes

CMS annually updates the durable medical equipment prosthetics, orthotic, and supplies (DMEPOS) for DME MAC and Part B MAC jurisdictions list.

Understanding repetitive scheduled non-emergent ambulance transports

Review these FAQs to learn more about the prior authorization for repetitive scheduled non-emergency ambulance transport.

Understanding prior authorization (PA) for certain hospital outpatient department (OPD) services

The following document was developed based on questions and answers posed during our webinars on the prior authorization (PA) program for certain hospital outpatient department (OPD) services.

Understanding prior authorization (PA) for certain hospital outpatient department (OPD) services

The following document was developed based on questions and answers posed during our webinars on the prior authorization (PA) program for certain hospital outpatient department (OPD) services.

Targeted probe and educate (TPE) round results: Wound care (CPT 11042 and 11045)

View targeted probe and educate (TPE) round results for wound care (CPT 11042 and 11045).

Targeted probe and educate (TPE) round results: Wound care (CPT 11042 and 11045)

View targeted probe and educate (TPE) round results for wound care (CPT 11042 and 11045).