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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…
Facet joint interventions may be used in pain management for chronic cervical/thoracic and lumbar/sacral pain arising from the paravertebral facet joints. Imaging guidance (fluoroscopy or CT per code descriptor) is used to assure accurate p…
View TPE round results for psychotherapy services.
Review the top denial / partial denial reasons and high-level results of evaluation and management services – emergency department visits TPE round results.
View this updated listing of targeted probe and educate (TPE) review topics.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for ambulance transports.
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 TPE round results for rehabilitation services outpatient (KX modifier).