Medical review
Targeted probe and educate (TPE) round results: Rehabilitation services outpatient
View these round results for rehabilitation services outpatient.
Prior authorization (PA) demonstration for certain ambulatory surgical center (ASC) services
CMS is implementing a five-year demonstration project for the prior authorization of certain services provided in Ambulatory Surgical Centers (ASCs) and will be implementing the demonstration in two…
Targeted probe and educate (TPE) round results: Inpatient rehabilitation facilities (IRF)
Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).
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 (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 (TPE) round results: Inpatient rehabilitation facilities (IRF)
Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).
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 December 2022 - May 2023.
Targeted probe and educate (TPE) round results: Evaluation and management services – initial 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.