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Targeted probe and educate (TPE) topics and schedule of review

Targeted probe and educate (TPE) is a process that combines a review of a sample of claims with education to help reduce claims submission errors. Learn more about TPE here.

The list below includes current TPE review topics, documentation checklists, and links to additional resources to assist you during the review process:

Part A TPE topics for review

Topic and education Related CPT / HCPCS Review status Documentation checklist  Results

Rehabilitation services (outpatient)

 97110, 97112, 97116 and 97140  Active Checklist: Therapy and rehabilitation services  Rehabilitation services results
Inpatient rehabilitation facility (IRF) services  N/A Active Checklist: Inpatient rehabilitation facility (IRF) IRF results

End-stage renal disease (ESRD) services 

 90999  Active Checklist: End-stage renal disease (ESRD) ESRD results
L37166 Wound care  11042 and 11045  Active Checklist: Wound debridement Wound care results
Skilled nursing facility (SNF) N/A Active Checklist: Skilled nursing facility (SNF) SNF results 

Diagnostic-related group (DRG)

 N/A Inactive Checklist: Endovascular cardiac valve replacement and supplement procedures DRG 226 and 267 results

Diagnostic-related group (DRG)

 N/A Inactive Checklist: Major hip and knee joint replacement or reattachment of lower extremity DRG 469 and 470 results
Outpatient hospital 93306 Active Checklist: Outpatient hospital services Transthoracic Echocardiography (TTE) coming soon

Part B TPE topics for review

Topic and education Related CPT / HCPCS Review status Documentation checklist Results

Rehabilitation services (outpatient)

 97110, 97112, 97116, 97124, 97140 and 97530  Active Checklist: Therapy and rehabilitation services 

Rehabilitation services results

Rehabilitation services with KX modifier results

Ambulance services

 A0428 and A0425  Inactive Checklist: Ambulance services Ambulance services results

Psychotherapy services

 90832, 90834 and 90837  Active Checklist: Psychotherapy services Psychotherapy services results

End-stage renal disease (ESRD) services

 90960  Active Checklist: End-stage renal disease (ESRD)  ESRD results
Evaluation and management (E/M) 99202-99205; 99211-99215; 99221-99223; 99231-99233; 99281-99284; 99285 Active Checklist: Evaluation and management (E/M)

Evaluation and management office visit results

Evaluation and management hospital visit results

Evaluation and management emergency department visit results
L36393 Laboratory services  87150, G0480, G0481, G0482, G0483 and G0659  Active Checklist: Laboratory services Laboratory services results
L33674 Diagnostic radiology  93975-93976 and 93978-93979 Inactive Checklist: Diagnostic radiology Diagnostic radiology results
Annual wellness visit (AWV) G0438 and G0439 Inactive Checklist: Annual wellness visit  Annual wellness visit results
Transitional care management (TCM) services 99495 and 99496 Inactive Checklist: Transitional care management services TCM results

Surgical services

Topic and education Related CPT / HCPCS Review status Documentation checklist Results
L33763 Vascular stenting of lower extremity arteries (Retired 05/05/2023) 37227 and 37229 Inactive Checklist: Vascular stenting lower extremities and endovascular revascularization Vascular stenting results

Cataract extraction

 66982, 66983 and 66984 Inactive Checklist: Cataract extraction  Cataract extraction results

Nail cutting / pairing and debridement

 11055, 11056, 11057, 11719, 11720, 11721 and G0127  Inactive Checklist: Nail cutting / paring and debridement  Routine foot care results
L33689 Mohs micrographic surgery (MMS) 17311, 17312, 17313, 17314 and 17315  Inactive Checklist: Mohs micrographic surgery Mohs micrographic surgery results
L37166 Wound care 11042 and 11045  Active Checklist: Wound debridement  Wound care results
L33818 Excision of malignant skin lesions 11102-11103,11200-11201, 11300-11303, 11305-11308, 11310-11313, 11400-1104, 11406,11420-11424, 11426, 11440-11444, 11446, 11600-11604, 11606, 11620-11624, 11626, 11640-11644 and 11646  Inactive Checklist: Skin lesion removal Skin lesion removal results

Drugs and biologicals

Topic and education Related CPT / HCPCS Review status Documentation checklist  Results
L34007 Intravenous immune globulin (IVIG)  J1569  Inactive Checklist: Drugs and biologicals  IVIG results
L32270 Bisphosphonates (intravenous [IV]) and monoclonal antibodies in the treatment of osteoporosis and their other indications (Retired 12/14/2023)  J0897 Inactive Checklist: Drugs and biologicals  Bisphosphonates injections with associated administration codes results
L33274 Botulinum toxins  J0585 Inactive Checklist: Drugs and biologicals  Botulinum toxin injection results
L33767 Viscosupplementation therapy for knee (Retired 04/06/2023)  J7318, J7320-J7329 and J7331-J7332  Inactive Checklist: Drugs and biologicals  Hyaluronan acid therapy injections with associated administration and placement codes results
L36377 Application of skin substitute grafts for treatment of DFU and VLU of lower extremities 15271, 15272, 15273, 15274, 15275, 15276, 15277 and 15278  Inactive Checklist: Application of skin substitutes Skin substitute round results