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 Connecticut policy.
CarePartners of Connecticut will implement the following claim edits:
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.
Provider Update is CarePartners of Connecticut’s quarterly newsletter for providers, hospital administrators and ancillary providers in the CarePartners of Connecticut network. Provider Update is CarePartners of Connecticut’s primary vehicle for providing 60-day notifications and other critical business-related information to providers.