Policy Updates Reimbursement PoliciesCommercialJanuary 1, 2021

Outpatient system updates for 2021 (Facility)

As a reminder, we will update our claim editing software monthly for outpatient facility services throughout 2021 with the most common updates occurring quarterly in 2021. These updates will:
  • reflect the addition of new, and revised codes (e.g. CPT, HCPCS, ICD-10, modifiers, Revenue Codes) and their associated edits
  • include appropriate use of various code combinations, which can include, but are not limited to, procedure code to revenue code, HCPCS to revenue code, type of bill to procedure code, type of bill to HCPCS code, procedure code to modifier, and HCPCS to modifier
  • include updates to National Correct Coding Initiative edits (NCCI) and medically unlikely edits (MUEs)
  • include updates to reflect coding requirements as designated by industry standard sources such as The National Uniform Billing Committee (NUBC)


 

937-0121-PN-GA