The following claim edits are effective for dates of service on or after July 1, 2021. These claim edits are derived from CMS, the AMA’s CPT Manual, HCPCS, ICD-10, nationally accredited societies and CarePartners of Connecticut payment policies.
CarePartners of Connecticut will implement claim edits for the following:
- Annual Wellness
- Duplicate Services
- Evaluation and Management Services
- Global Surgery
- Hydration Therapy
- Diagnosis to Procedure Code Conflicts
- Intrauterine Contraceptive Systems and Contraceptive Implants
- Laboratory and Pathology
- Obstetrics and Gynecology
- Once Per Lifetime
- Place of Service
These claim edits are documented in the applicable CarePartners of Connecticut payment policies available in the Provider Resource Center on the public Provider website.