Marketplace
Marketplace
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Add-on Coding - Advanced Beneficiary Notice ABN Modifiers GA GX GY GZ
- Anesthesia Bundling
- CMS Replacement Codes
- Condition Codes 49, 50, and 53
- Co Surgeon Team Surgeon Professional
- Critical Care Codes when Discharging Home from the Emergency Department
- Decision for Surgery Modifier 57
- Diagnosis Code Coding
- Diagnosis Code Y65 XX
- Discontinued Procedures
- Emergency EM Codes and Place of Service
- Facility Bilateral or Anatomical Modifier Use
- Global Surgical Packages for Professional Providers
- Hospice Value Code 61
- Hydrolyzed Enteral Formula Diagnosis
- ICD-10 First Listed Diagnosis Coding Policy
- ICD-10 Specificity
- Incarceration Diagnosis Code
- Inpatient services billed on Outpatient bill types
- Medically Unlikely Edits
- Member PCP as Attending Provider in a ER Facility Setting
- Modifier 25
- Modifier 26
- Modifier KX
- Modifier TC
- Modifiers XE XS XP XU and 59 Usage
- Multiple EM codes for the same provider same date of service
- NCCI PTP with Modifiers
- PT OT ST Yearly Limit
- PT OT Initial Evaluations
- Podiatric Q Modifiers
- Reduced Services and Discontinued Procedures
- Repeat Procedure Modifiers 76 77
- Status Indicator Flag B Bundled Codes
- Tendon Injections Missing Diagnosis
- Therapy Modifier Coding
- Unlisted Coding
- Unspecified Codes in an Inpatient Setting
- Breast Cancer Genetic Testing Tier 1 vs Tier 2
- DRG Clinical Validation
- Facility Emergency Department Evaluation and Management leveling
- High Level Evaluation and Management with Preventive Medicine
- Hospice
- Hospital Routine Supplies Services
- Newborn and NICU
- Observation
- Optum EDC Analyzer - Facility ER E&M Leveling Prepayment
- Psychotherapy Add On with High Level EM
- Readmission
- Sepsis
- Split-Night-Sleep-Study
- G2031 Allergen Testing
- Allergy Testing
- G2022 Biomarker Testing for Autoimmune Rheumatic Disease
- G2150 Biomarkers for Myocardial Infarction and Chronic Heart Failure
- G2050 Cardiovascular Disease Risk Assessment
- Clinical Diagnostic Laboratory Services
- G2181 Colorectal Cancer Screening Prior Variance
- G2174 Coronavirus Testing in the Outpatient Setting
- G2006 Diabetes Mellitus Testing
- M2057 Diagnosis of Vaginitis Prior Variance
- G2011 Diagnostic Testing of Iron Homeostasis Metabolism
- G2138 Evaluation of Dry Eyes
- F2019 Flow Cytometry
- G2154 Folate Testing
- G2155 General Inflammation Testing
- G2044 Helicobacter pylori Testing
- G2036 Hepatitis Testing
- M2116 Human Immunodeficiency Virus HIV
- M2097 Identification of Microorganisms using Nucleic Acid Probes
- G2099 Intracellular Micronutrient Analysis
- Lab Codes with Modifiers 59 and 91
- Lab Panel
- R2162 Laboratory Procedures Reimbursement
- Labs Overlapping with Facility
- G2143 Lyme Disease Testing
- Non-Invasive Prenatal Testing
- M2172 Onychomycosis Testing
- Packaged and conditionally packaged lab services
- G2153 Pancreatic Enzyme Testing for Acute Pancreatitis
- G2164 Parathyroid Hormone Phosphorus Calcium and Magnesium Testing
- G2149 Pathogen Panel Testing
- G2042 Pediatric Preventive Screening
- Physician Office Laboratory Testing
- G2035 Prenatal Screening Nongenetic Prior Variance
- G2008 Prostate Specific Antigen PSA Testing
- Respiratory Pathogen Panel Testing
- M2041 RTM Venous and Arterial Thrombosis Risk Testing
- G2120 Salivary Hormone Testing
- G2151 Serum Testing For Evidence of Mild Traumatic Brain Injury
- G2124 Serum Tumor Markers for Malignancies
- Specimen Validity Testing
- STI Lab Panel Testing
- G2045 Thyroid Disease Testing
- G2125 Urinary Tumor Markers for Bladder Cancer
- G2014 Vitamin B12 and Methylmalonic Acid Testing
- G2005 Vitamin D Testing
- After Hours and Weekend Care Professional
- Authorization Review
- Corrected Claims
- Duplicate Claims
- Fee Schedule
- General Billing and Coding Policy
- Medical Supplies Home Health Consolidated Billing
- Member Not Active
- Multiple Procedure Payment Reduction
- Overlapping Room and Board
- Paid Amount Exceeded Billed Amount
- Recovery Policy for CPT to CPT Code
- Recovery Policy for Diagnosis Codes
- Recovery Policy for Revenue to CPT Code Review
- Recovery Policy Variable Discount Payments for Providers
- Semiprivate Vs Private Room
- Ambulatory Echocardiograph Monitoring
- Aortography and Peripheral Angiography
- Autonomic FunctionTesting
- CT Computed Tomography of the Abdomen and Pelvis
- Colonoscopy and Sigmoidoscopy
- Electrocardiographic EKG or ECG Monitoring Holter or Real Time Monitoring
- Image Guided Radiation Therapy
- Radiology Bone Density
- Radiology for chest
Medicare
Medicare
- Add-on Coding
- Advanced Beneficiary Notice ABN Modifiers GA GX GY GZ
- Anesthesia Bundling
- CMS Replacement Codes
- Co Surgeon Team Surgeon Professional
- Critical Care Codes when Discharging Home from the Emergency Department
- Decision for Surgery Modifier 57
- Diagnosis Code Coding
- Diagnosis Code Y65 XX
- Discontinued Procedures
- Emergency EM Codesand Place of Service
- Facility Bilateralor Anatomical Modifier Use
- Global Surgical Packages for Professional Providers
- Hospice Value Code 61
- ICD-10 First Listed Diagnosis Coding Policy
- ICD-10 Specificity
- Incarceration Diagnosis Code
- Inpatient services billed on Outpatient bill types
- Medically Unlikely Edits
- Member PCP as Attending Provider in a ER Facility Setting
- Modifier TC
- Modifier 25
- Modifier 26
- Modifier KX
- Modifiers XE XS XP XU and 59 Usage
- Multiple EM codes for the same provider same date of service
- NCCI PTP with Modifiers
- NPFS Status Indicator T
- Physical Therapy Max Units Per Day
- Podiatric Q Modifiers
- PT OT Initial Evaluations
- PT OT ST Yearly Limit
- Reduced Services and Discontinued Procedures
- Repeat Procedure Modifiers 76 77
- Status Indicator Flag B Bundled Codes
- Tendon Injections Missing Diagnosis
- Therapy Modifier Coding
- Unlisted Coding
- Unspecified Codes in an Inpatient Setting
- Breast Cancer Genetic Testing Tier 1 vs Tier 2
- DRG Clinical Validation
- Excludes 1 Note
- Facility Emergency Department Evaluation and Management leveling
- High Level Evaluation and Management with Preventive Medicine
- Hospice
- Newborn and NICU
- Non-Invasive Prenatal Testing
- Observation
- Optum Pause and Pay
- Optum EDC Analyzer - Facility ER E&M Leveling Prepayment
- Psychotherapy Add On with High Level EM
- Readmission
- Sepsis
- Split-Night-Sleep-Study
- Allergy Testing
- Clinical Diagnostic Laboratory Services
- Lab Panel
- Labs Overlapping with Facility
- Packaged and conditionally packaged lab services
- Physician Office Laboratory Testing
- Respiratory Pathogen Panel Testing
- STI Lab Panel Testing
- Specimen Validity Testing
- F2019 Flow Cytometry
- G2005 Vitamin D Testing
- G2006 Diabetes Mellitus Testing
- G2008 Prostate Specific Antigen PSA Testing
- G2011 Diagnostic Testing of Iron Homeostasis Metabolism
- R2162 Laboratory Procedures Reimbursement
- M2172 Onychomycosis Testing
- M2116 Human Immunodeficiency Virus HIV
- M2097 Identification of Microorganisms using Nucleic Acid Probes
- M2057 Diagnosis of Vaginitis Prior Variance
- M2041 RTM Venous and Arterial Thrombosis Risk Testing
- G2181 Colorectal Cancer Screening Prior Variance
- G2174 Coronavirus Testing in the Outpatient Setting
- G2164 Parathyroid Hormone Phosphorus Calcium and Magnesium Testing
- G2155 General Inflammation Testing
- G2154 Folate Testing
- G2153 Pancreatic Enzyme Testing for Acute Pancreatitis
- G2151 Serum Testing For Evidence of Mild Traumatic Brain Injury
- G2150 Biomarkers for Myocardial Infarction and Chronic Heart Failure
- G2149 Pathogen Panel Testing
- G2143 Lyme Disease Testing
- G2138 Evaluation of Dry Eyes
- G2125 Urinary Tumor Markers for Bladder Cancer
- G2124 Serum Tumor Markers for Malignancies
- G2120 Salivary Hormone Testing
- G2099 Intracellular Micronutrient Analysis
- G2050 Cardiovascular Disease Risk Assessment
- G2045 Thyroid Disease Testing
- G2044 Helicobacter pylori Testing
- G2042 Pediatric Preventive Screening
- G2036 Hepatitis Testing
- G2035 Prenatal Screening Nongenetic Prior Variance
- G2031 Allergen Testing
- G2022 Biomarker Testing for Autoimmune Rheumatic Disease
- G2014 Vitamin B12 and Methylmalonic Acid Testing
- After Hours and Weekend Care Professional
- Annual Wellness Visit sooner than 11 months following Initial IPPE
- Authorization Review
- Corrected Claims
- Cross-Departmental Recovery Policy
- Duplicate Claims
- Fee Schedule
- General Billing and Coding Policy
- MemberNotActive12162024l
- Multiple Procedure Payment Reduction
- Overlapping Room and Borad
- Paid Amount Exceeded Billed Amount
- Recovery Policy for CPT to CPT Code
- Recovery Policy for Diagnosis Codes
- Recovery Policy for Revenue to CPT Code Review
- Recovery Policy Variable Discount Payments for Providers
- Semiprivate Vs Private Room
- Ambulatory Echocardiograph Monitoring
- Aortography and Peripheral Angiography
- Autonomic FunctionTesting
- CT Computed Tomography of the Abdomen and Pelvis
- Colonoscopy and Sigmoidoscopy
- Electrocardiographic EKG or ECG Monitoring Holteror Real Time Monitoring
- Image Guided Radiation Therapy
- Pulmonary Function Testing
- Radiology Bone Density
- Radiology for chest
Medicaid (OH)
Medicaid (OH)
- Add-on Coding
- Advanced Beneficiary Notice ABN Modifiers GA GX GY GZ
- Anesthesia Bundling
- Co-Surgeon / Team Surgeon
- CMS Replacement Codes
- Critical Care Codes when Discharging Home from the Emergency Department
- Decision for Surgery Modifier 57
- Diagnosis Code Coding
- Diagnosis Code Y65.XX
- Discontinued Procedures
- Emergency Service E&M Codes and Place of Service 23
- Facility Bilateral or Anatomical Modifier Use
- Global Surgical Packages for Professional Providers
- Hospice Value Code 61
- Inpatient services billed on Outpatient bill types
- Medically Unlikely Edits
- Modifier 25
- Modifier KX
- Modifier TC
- Multiple EM codes for the same provider same date of service
- NCCI PTP with Modifiers
- PT OT Initial Evaluations
- Physical Therapy Max Units Per Day
- Podiatric Q Modifiers
- Repeat Procedure Modifiers 76 77
- Status Indicator Flag B Bundled Codes
- Tendon Injections Missing Diagnosis
- Unlisted Coding
- Unspecified Codes in an Inpatient Setting
- Breast Cancer Genetic Testing Tier 1 vs Tier 2
- DRG Clinical Validation
- Facility Emergency Department Evaluation and Management leveling
- High Level Evaluation and Management with Preventive Medicine
- Hospice
- Hospital Routine Supplies Services
- Newborn and NICU
- Observation
- Psychotherapy Add On with High Level EM
- Readmission
- Sepsis
- Split-Night-Sleep-Study
- After Hours and Weekend Care Professional
- Annual Wellness Visit sooner than 11 months following Initial IPPE
- Cross-Departmental Recovery
- Duplicate Claims
- Fee Schedule
- General Billing and Coding Policy
- Member Not Active
- Multiple Procedure Payment Reduction
- Overlapping Room and Board
- Paid Amount Exceeded Billed Amount
- Recovery Policy for Billed Units Service Accumulator
- Recovery Policy for CPT-to-CPT Code Review Policy
- Recovery Policy for Diagnosis Codes Policy
- Recovery Policy for Revenue to CPT Code Review
- Recovery Policy for Variable Discount Payments for Providers
- Ambulatory Echocardiograph Monitoring
- Aortography and Peripheral Angiography
- Autonomic FunctionTesting
- Colonoscopy and Sigmoidoscopy
- CT Computed Tomography of the Abdomen and Pelvis
- Electrocardiographic EKG or ECG Monitoring Holter or Real Time Monitoring
- Image Guided Radiation Therapy
- Non Invasive Abdominal Visceral Vascular Studies
- Pulmonary Function Testing
- Radiology Bone Density
- Radiology for chest