Service-specific reviews
View these current post-payment service-specific reviews and available results.
Articles
Article Type
Category
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).
Checklist: Chemotherapy, drugs, biologicals, and injection services
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for...
Checklist: Evaluation and management (E/M) services documentation
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation...
Part B service-specific review – clinical laboratory lipid panel (80061)
Summary for clinical laboratory lipid panel (June and July 2021).
Part B service-specific review – clinical laboratory presumptive and definitive drug testing
Summary for Clinical Labs (November 2020).
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...
Part B service-specific review – drugs and biologicals (J0178 Eylea, J0897 Prolia, J2778 Lucentis, J9217 Lupron (Leuprolide))
Summary for drugs and biologicals (April-May 2021).
Clinical trials background
Medicare covers the routine costs of qualifying clinical trials, as such costs are defined in National Coverage Determination...
Part B service-specific review -- hyperbaric oxygen therapy (CPT code 99183)
Summary for hyperbaric oxygen therapy (October 2020).