Read Article
August 18, 2021
NCQA Kidney Health Flyer Reinforces Importance of Regular Screening
Currently in its first year of implementation, the new HEDIS measure Kidney Health Evaluation for Patients With Diabetes (KED) includes this measure description: The percentage of members 18-85 years of age with diabetes (type 1 or type 2) who received kidney health evaluation, defined by an estimated glomerular filtration rate (eGFR) AND a urine albumin…
#Network in the Know
Read Article
June 23, 2021
Value-based specialty care programs: Focus on cardiology
As a means of improving health outcomes, increasing member and provider satisfaction, and reducing the high cost of care, CDPHP is investing in its network specialists by creating a number of value-based specialty care programs. The initiative, which builds on the strategies applied to our Enhanced Primary Care program, affords our specialty care providers increased…
#Network in the Know
Read Article
June 11, 2021
Code Auditing Changes Effective June 16, 2021
Quarterly, Capital District Physicians’ Health Plan, Inc. (CDPHP®) implements appropriate code auditing changes to remain current with industry standard coding updates. Updates are made to our code auditing software – Change Healthcare Technologies, LLC ClaimsXten™ – based on recommendations from a variety of sources, including the American Medical Association (AMA), Centers for Medicare and Medicaid…
#Network in the Know
Read Article
June 02, 2021
What you need to know about Avalon for genetic testing
CDPHP® is proud to announce a new laboratory benefit management program in collaboration with Avalon Healthcare Solutions (Avalon). CDPHP genetic testing policies will be enforced by Avalon through prior authorization starting January 18, 2022. Providers of laboratory services (both referring and performing) will need to be aware of this new program, as collectively we have an obligation…
#Network in the Know
Read Article
May 07, 2021
Coding Tips for Actual or Suspected Exposure to COVID-19: ICD-10 Code Z20.822
Since the COVID-19 public health emergency was declared, diagnosis codes for reporting actual or suspected exposure to COVID-19 have been updated. This article provides coding tips, based on the current official 2021 ICD-10 guidelines, for using the new ICD-10 diagnosis code Z20.822. This diagnosis code can be reported for dates of service on or after…
#Network in the Know
Read Article
March 29, 2021
First-Quarter 2021 Coding Changes Announced
Quarterly, Capital District Physicians’ Health Plan, Inc. (CDPHP®) implements appropriate code auditing changes to remain current with industry standard coding updates. Updates to Change Healthcare Technologies, LLC ClaimsXten™, our code auditing software, are based on recommendations from a variety of sources, including the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS) Correct…
#Network in the Know
The Daily Dose