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This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for AWV. Health care providers retain responsibility to submit complete and accurate documentation.
The Comparative Billing Report (CBR) for Part B providers furnishes a detailed examination of the comparative data that Medicare considers when determining how the provider’s billing patterns contrast with those of other providers of the sa…
Review the top denial/partial denial reasons and high-level results from each round of DRG 226 and 267 TPE.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for transitional care management (TCM) services.
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.
View targeted probe and educate (TPE) round results for ambulance services: basic life support non-emergent transport and mileage (HCPCS A0428 and A0425).
Learn about various programs which focus on ensuring Medicare compliance. Topics include: Comprehensive error rate testing (CERT), prior authorization, and targeted probe and educate.
Review the top denial / partial denial reasons and high-level results listed below from each round of JN ESRD TPE reviews.
View targeted probe and educate (TPE) round results for end stage renal disease (ESRD).
View this updated listing of targeted probe and educate (TPE) review topics.