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December 20, 2021
Code auditing changes effective December 15, 2021
For claims processed on or after December 15, 2021, 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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November 15, 2021
If lack of staff is slowing down your billing, coding, and other tasks—here’s a solution
Your main focus as a provider is where it should be—on quality of care and your patient’s health. This important mission shouldn’t be compromised by having to worry about administrative needs for billing, claims, and proper coding. Utilizing a medical billing company can allow you and your team to do what you do best, care…
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September 24, 2021
Summary of new code auditing changes September 2021
For claims processed on or after September 22, 2021, 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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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…
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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…
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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…
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