Payment Integrity Policies
Molina Healthcare Medicare and Marketplace Payment Integrity Payment Policies
For Molina Healthcare Active Medicare and Marketplace, Please click the link.
Molina Healthcare Medicare and Marketplace Payment Integrity Payment Policies- Add-on Coding
- Anesthsia Bundling
- Colonoscopies and Sigmoidoscopy
- Co Surgeon Team Surgeon Professional
- Global Surgical Packages for Professional Providers
- Hydrolyzed Enteral Formula Diagnosis
- Injection and Infusions in the ER with 25 Modifier
- Medically Unlikely Edits
- NPFS Status Indicator T
- Modifier 25
- Modifier 26
- Modifier KX
- Modifier TC
- Podiatric Q Modifiers
- Psychotherapy Add On with High Level EM
- Tendon Injections Missing Diagnosis
- Therapy Modifier Coding
- Appropriate Level of Care Reimbursement
- Breast Cancer Genetic Testing Tier 1 vs Tier 2
- Critical Care Codes when Discharging Home from the Emergency Department
- Diagnosis Code Coding
- DRG Clinical Validation
- Excludes 1 Note
- High Level Evaluation and Management with Preventive Medicine
- High Dollar Pharmacy
- Hospital Routine Supplies Services
- ICD-10 First Listed Diagnosis Coding Policy
- ICD-10 Specificity Coding Policy
- Newborn and NICU
- Readmission
- Sepsis
- Split-Night-Sleep-Study
- Observation