Understanding E/M office or other outpatient services
The A/B MACs partnered together to answer practitioners’ top questions related to evaluation and management (E/M) office and...
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Targeted probe and educate (TPE) round results: Major hip and knee replacement (DRG 470)
Review the top denial / partial denial reasons and high-level results from each round of DRG 470 TPE.
Targeted probe and educate (TPE) round results: Evaluation and management services – emergency department visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services – emergency...
Breakdown of Common Minimum Data Set (MDS) errors
The MDS is a tool used for implementing standardized assessment and for facilitating care management in skilled nursing homes...
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...
E/M: Reviewing amount and/or complexity of data
For the element of medical decision making addressing the amount and/or complexity of data to be reviewed and analyzed, the AMA...
Targeted probe and educate (TPE) round results: Endovascular cardiac valve replacement and supplement procedure (DRG 266 & 267)
Review the top denial/partial denial reasons and high-level results from each round of DRG 226 and 267 TPE.
Understanding repetitive scheduled non-emergent ambulance transports
Review these FAQs to learn more about the prior authorization for repetitive scheduled non-emergency ambulance transport.
Checklist: Paravertebral facet joint injection services documentation
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation...
Checklist: Community mental health centers (CMHC) or partial hospitalization program (PHP)
This checklist is an aid to assist providers when responding to medical record documentation requests pertaining to community...