Medical review
Targeted probe and educate (TPE) round results: Evaluation and management services - outpatient office visits
View TPE round results for evaluation and management services - outpatient office visits.
Targeted probe and educate (TPE) round results: Drugs and biologicals (HCPCS J7318-J7329, J7331-J7332)
View TPE round results for drugs and biologicals (HCPCS J7318-J7329, J7331-J7332).
Targeted probe and educate (TPE) round results: Drugs and biologicals (HCPCS J7318-J7329, J7331-J7332)
View TPE round results for drugs and biologicals (HCPCS J7318-J7329, J7331-J7332).
Targeted probe and educate (TPE) round results: Evaluation and management services - outpatient office visits
View TPE round results for evaluation and management services - outpatient office visits.
Hospital outpatient department (OPD) prior authorization exemption process
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to prior authorization (PA) may be eligible for exemption. This exemption…
Hospital outpatient department (OPD) prior authorization exemption process
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to prior authorization (PA) may be eligible for exemption. This exemption…
Ambulance Prior Authorization Documentation Requirements
Review this checklist to learn about the documentation requirements to ensure an affirmed decision on your prior authorization request (PAR) for repetitive, scheduled, non-emergency transport.
Fast facts: CERT vaccine and roster billed claims
Read this article to learn more about CERT reviews for vaccine and roster billed claims.
Fast facts: CERT vaccine and roster billed claims
Read this article to learn more about CERT reviews for vaccine and roster billed claims.
Blepharoplasty, eyelid surgery, brow lift, and related services
Blepharoplasty, blepharoptosis repair and brow lift are surgeries that may be performed to improve function or provided strictly for cosmetic reasons. Functional or reconstructive eyelid surgery is…