Medical review
Attention exempt hospital outpatient departments (OPDs): Revised additional documentation request (ADR) letters
Due to a claim issue identified, exempt hospital OPDs will be receiving a revised exemption ADR letter with a revised letter fax cover sheet.
Claims with CPT code 90658, influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use, pricing incorrectly
Payment issue affecting CPT code 90658, influenza virus vaccine.
Payment issue affecting end stage renal dialysis services on type of bill 72X
Payment issue affecting end stage renal dialysis services on type of bill 72X.
Claims with CPT code 90658, influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use, pricing incorrectly
Payment issue affecting CPT code 90658, influenza virus vaccine.
Pathology and laboratory codes requiring documentation
Avoid negative impacts to your claims by providing medical records with your initial claim submission for the pathology and lab codes listed below.
Pathology and laboratory codes requiring documentation
Avoid negative impacts to your claims by providing medical records with your initial claim submission for the pathology and lab codes listed below.
CPT Category III T Codes requiring documentation
Avoid negative impacts to your claims by providing medical records with your initial claim submission for the T codes listed below.
CPT Category III T Codes requiring documentation
Avoid negative impacts to your claims by providing medical records with your initial claim submission for the T codes listed below.
Medical necessity requirements for skilled nursing facility (SNF) admissions
This questionnaire is intended to provide health care providers with a reference for use when screening a new patient for a SNF admission. This criteria is required to meet Medicare guidelines for a…
Medical necessity requirements for skilled nursing facility (SNF) admissions
This questionnaire is intended to provide health care providers with a reference for use when screening a new patient for a SNF admission. This criteria is required to meet Medicare guidelines for a…