Medical review
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).
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…
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…
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…
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…
Skin substitute graft for treatment of DFU and VLU lower extremities (15271-15278)
View targeted probe and educate (TPE) round results for 15271-15278.