Claim edit enhancements for outpatient facility claims

Beginning in May 2019, we will enhance our claims editing systems to include outpatient facility editing.

 

These edits will: 

• Help ensure correct coding and billing practices are being followed
• Help ensure compliance with industry standards such as American Medical Association (AMA), National Uniform Billing Committee (NUBC), and national specialty and academy guidelines
• Reinforce compliance with standard code edits and rules (i.e., CPT, HCPCS, ICD-10, NUBC)