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Targeted probe and educate (TPE) round results: Clinical laboratory services

May 18, 2026
View targeted probe and educate (TPE) round results for clinical laboratory services.

Targeted probe and educate (TPE) round results: Diagnostic-related group (DRG) 885 - psychosis

May 18, 2026
Review the top denial / partial denial reasons and high-level results listed for DRG 885.

Targeted probe and educate (TPE) round results: Inpatient rehabilitation facilities (IRF)

May 18, 2026
Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).

Signature guidelines: 20-day timeframe for additional documentation requests

May 19, 2026
When a medical reviewer contacts the provider requesting to submit an attestation statement or signature log to authenticate a medical record, the provider must submit the attestation statement or signature log within 20-calendar days.

Skin substitute graft for treatment of DFU and VLU lower extremities (15271-15278)

March 25, 2026
View targeted probe and educate (TPE) round results for 15271-15278.

Understanding prior authorization (PA) for certain hospital outpatient department (OPD) services

April 21, 2026
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.

Fast facts: CERT administrative relief during a disaster

March 18, 2026
Read this article for information about how CERT may grant temporary administrative relief to certain affected providers and suppliers during a disaster.

Rhinoplasty and related services

March 16, 2026
Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.

Targeted probe and educate round results: Transitional care management

February 27, 2026
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 Review.
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