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Claim Edits
The following claim edits are effective for dates of service on or after July 1, 2019. These policies are derived from CMS, the AMA’s Current Procedural Terminology Manual, the Healthcare Common Procedure Coding System, ICD-10, nationally accredited societies and CarePartners of...
Correct Coding Reminder
As a routine business practice, claims are subject to payment edits that are updated at regular intervals and generally based on CMS (including the National Correct Coding Initiative [NCCI] edits), specialty society guidelines and drug manufacturers’ package label inserts.
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Change in Process for DRG Validation
Effective July 1, 2019, CarePartners of Connecticut will implement changes to the DRG Validation of Inpatient Hospitals Policy. As part of this change:
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