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Service-specific reviews

December 23, 2025
View these current post-payment service-specific reviews and available results.

Medical review activities

December 23, 2025
Service-specific reviews

Skilled nursing facility (SNF) 5-claim probe and educate (P&E) round results

December 23, 2025
View this article to view the results for the SNF 5-claim probe and educate (P&E).

Targeted probe and educate (TPE) round results: Endovascular cardiac valve replacement and supplement procedure (DRG 266 & 267)

December 23, 2025
Review the top denial/partial denial reasons and high-level results from each round of DRG 226 and 267 TPE.

ADR (Additional documentation requests)

December 23, 2025
Find information and resources that will help you properly respond to additional documentation requests within required timeframes.

Targeted probe and educate (TPE) round results: Major hip and knee replacement (DRG 470)

December 23, 2025
Review the top denial / partial denial reasons and high-level results from each round of DRG 470 TPE.

Targeted probe and educate (TPE) round results: Evaluation and management services – emergency department visits

December 23, 2025
Review the top denial / partial denial reasons and high-level results of evaluation and management services – emergency department visits TPE round results.

Targeted probe and educate round results: Annual wellness visits (AWV)

December 23, 2025

Checklist: Paravertebral facet joint injection services documentation

December 23, 2025
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for paravertebral facet joint injection services.

Part B service-specific review – clinical laboratory presumptive and definitive drug testing

December 23, 2025
Summary for Clinical Labs (November 2020).
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