Checklist: Cardiac rehabilitation services
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for...
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Targeted probe and educate (TPE) round results: Diagnostic-related group (DRG) 885 - psychosis
Review the top denial / partial denial reasons and high-level results listed for DRG 885.
Targeted probe and educate (TPE) round results: Clinical laboratory services (CPT 87150)
View targeted probe and educate (TPE) round results for clinical laboratory services: culture, typing; identification by nucleic...
Prior authorization program for certain hospital outpatient department services - claim submission guidelines
Claims submitted for a prior authorization request (PAR) that received a provisional affirmation PA decision, including any...
Prior authorization: Facet joints and cervical fusion
CMS has removed CPT codes 64492 and 64495 from the listing of codes requiring prior authorization. View our article to learn...
Prior authorization fax coversheet
CMS is implementing a prior authorization program for certain hospital outpatient department services for dates of service on or...
Prior authorization (PA) for hospital outpatient department (OPD) services: tips and reminders
The following are tips and reminders that will assist providers in avoiding a delay or dismissal of a prior authorization...
Provider documentation tool for non-emergent ambulance transportation
This article is designed to assist medical providers with documenting the beneficiary’s medical condition supporting coverage...
Checklist: Drugs and Biologicals
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation...