Claim Edits

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.