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December 09, 2022
Cancer screening guidelines – what’s the latest?
Keeping up with evolving recommendations about cancer screening is a challenge. To make sure we are always up to date, and helping you to do the same, CDPHP continually monitors society guidelines as well as the quality metrics that providers and health plans must meet to ensure our members are getting the best and most…
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November 18, 2022
Code auditing changes effective December 7, 2022
For claims processed on or after December 7, 2022, you may notice differences related to changes in code pairs in CCI, which includes modifier override changes; daily frequency limits; incidental, mutually exclusive and unbundled code edits; assistant surgeon eligibility; modifier to procedure compatibility; evaluation of incomplete diagnosis; global surgery pre-operative and post-operative periods as defined…
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June 27, 2022
Code auditing changes effective June 15, 2022
For claims processed on or after June 15, 2022, you may notice differences related to changes in code pairs in CCI, which includes modifier override changes; daily frequency limits; incidental, mutually exclusive and unbundled code edits; assistant surgeon eligibility; modifier to procedure compatibility; evaluation of incomplete diagnosis; global surgery pre-operative and post-operative periods as defined…
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April 21, 2022
Exclusions to the HEDIS Low Back Pain measure
In our ongoing effort to improve overall performance with the HEDIS Low Back Pain (LBP) measure, CDPHP is sharing information on measure exclusions. What this means is if the following condition is appropriate to your patient and coded as such, the member would be excluded and not count against your overall performance. Exclude members who…
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March 23, 2022
If you care for children, you can help prevent cancers
Evidence continues to mount that the HPV vaccine dramatically reduces the risk of cervical cancer, the most common cancer in young women. A recent study published in The Lancet journal showed that girls 12 to 13 years of age receiving HPV vaccine had an 87% risk reduction for cervical cancer and a 97% risk reduction…
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March 21, 2022
Code auditing changes effective March 23, 2022
For claims processed on or after March 23, 2022, you may notice differences related to changes in code pairs in CCI, which includes modifier override changes; daily frequency limits; incidental, mutually exclusive and unbundled code edits; assistant surgeon eligibility; modifier to procedure compatibility; evaluation of incomplete diagnosis; global surgery pre-operative and post-operative periods as defined…
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