Medical review
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 after July 1, 2020.
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 after July 1, 2020.
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 requests for nail cutting / paring and debridement services.
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 requests for nail cutting / paring and debridement services.
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: Rehabilitation services outpatient
View these round results for rehabilitation services outpatient.
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: 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 December 2022 - May 2023.
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).