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Payment Integrity Policies

 

  • Coding Policies

    PI Coding Policy General

    PI Coding Policy Diagnosis Code

    PI Coding Policy ICD-10 Specificity

    PI Coding Policy Lab Codes with Modifiers 59 and 91

    PI Coding Policy Modifier 26

    PI Coding Policy Modifier KK

    PI Coding Policy Modifier TC

    PI Coding Policy Packaged and conditionally packaged lab services

    PI Coding Policy Therapy Modifier

    PI Coding Policy NCCI PTP with Modifiers

    PI Code Coding Policy Add-On

    PI Coding Policy Ambulance Modifier

    PI Coding Policy Medically Unlikely Edits

    PI Coding Policy Decision for Surgery

    PI Coding Policy Lab Panel

    PI Coding Policy Image Guided Radiation Therapy

    PI Coding Policy Non-Invasive Prenatal Testing

    PI Coding Policy ICD-10 First Listed Diagnosis

    PI Coding Policy Excludes1 Note

  • Payment Policies

    PI Payment Policy 38 Critical Care Codes when Discharging Home
    PI Payment Policy Hospital Routine Supplies Services Reimbursement 

    PI Payment Policy 35 Breast Cancer Genetic Testing Tier 1 vs Tier 2

    PI Payment Policy 47 Psychotherapy Add-On with High Level EM

    PI Payment Policy 36 Hydrolyzed Enteral Formula Diagnosis

    PI Payment Policy 37 High-Level EM with Preventive Medicine

    PI Payment Policy 46 Split-Night Sleep Study

    PI Payment Policy 42 Corrected Claim Reimbursement Policy
    PI Payment Policy 45 Duplicate claim reimbursement policy

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