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View this updated listing of targeted probe and educate (TPE) review topics.
Review the top denial / partial denial reasons and high-level results of evaluation and management services – emergency department visits TPE round results.
Review the top denial / partial denial reasons and high-level results from each round of DRG 470 TPE.
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process allows the provider to submit documentation prior to providing or billing the service. The contractor will then al…
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.
Find information and resources that will help you properly respond to additional documentation requests within required timeframes.
View targeted probe and educate (TPE) round one results for surgical services: endovascular revascularization (open or percutaneous, transcatheter) procedures CPT 37229 from October 2021 - April 2022.
View targeted probe and educate (TPE) round one results for rehabilitation services.
View targeted probe and educate (TPE) for surgical services - cataract extraction (CPT 66982-66984).
View targeted probe and educate (TPE) round results for 15271-15278.