Medical review
Checklist: Surgical services - Cataract extraction
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for surgical services: cataract extraction.
Understanding prior authorization (PA) for certain hospital outpatient department (OPD) services
The following document was developed based on questions and answers posed during our webinars on the prior authorization (PA) program for certain hospital outpatient department (OPD) services.
Understanding prior authorization (PA) for certain hospital outpatient department (OPD) services
The following document was developed based on questions and answers posed during our webinars on the prior authorization (PA) program for certain hospital outpatient department (OPD) services.
Targeted probe and educate (TPE) round results: Evaluation and management services – initial inpatient care visits and subsequent inpatient care visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services - initial inpatient care visits and subsequent inpatient care visits TPE round results.
Targeted probe and educate (TPE) round results: Evaluation and management services – initial inpatient care visits and subsequent inpatient care visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services - initial inpatient care visits and subsequent inpatient care visits TPE round results.
Targeted probe and educate (TPE) round results: End stage renal disease (ESRD) (CPT 90999)
Review the top denial / partial denial reasons and high-level results listed below from each round of JN ESRD TPE reviews.
Targeted probe and educate round results: Transitional care management
Top denial/ partial denial reasons and high-level results are listed below from each round of Transitional Care Management (TCM) services TPE reviews that have been conducted thus far by Medical…
Targeted probe and educate (TPE) round results: Rehabilitation services outpatient (KX modifier)
View TPE round results for rehabilitation services outpatient (KX modifier).
Targeted probe and educate (TPE) round results: Rehabilitation services outpatient
View these round results for rehabilitation services outpatient.
Targeted probe and educate (TPE) round results: End stage renal disease (ESRD) (CPT 90999)
Review the top denial / partial denial reasons and high-level results listed below from each round of JN ESRD TPE reviews.