Procedure Codes Sample Clauses

Procedure Codes. ‌ Many MCEs accept and use non-standard codes such as State specific and MCE specific codes. Current validating process at EHS DW looks for standard codes only - CPT, HCPCS, and ADA. HIPPAA regulations require that only standard HCPCS Level I (CPT) and II be used for reporting and data exchange. The only field containing HCPCS Level 1 and II procedure codes is the Procedure Code field (#26). ICD-10 PCS procedure codes should be populated in the Surgical Procedure Code fields (103-111, 206-221).
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Procedure Codes. VR Central Office will establish procedure codes for all vocational, non-medical services provided for clients.
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Procedure Codes.  The current state-defined procedure code set will be required by the system, and must be used in all claims. A copy of acceptable procedure code set can be obtained by contacting xxxxxxxxxx@xxxxx.xxx or call (000) 000-0000 (ask for Claims Unit)  The MDHHS code set is consistently under development by the state. Any additions and changes will be forwarded to the provider as soon as they are available. Diagnostic Codes  ICD 10 coding system and descriptors must be utilized in accordance with national standards.  Primary diagnosis must be appropriate for services provided under this agreement listed on claim to avoid rejection. Primary diagnosis code must be listed one of the diagnosis codes accepted by the Michigan Department of Health and Human Services, if appropriate. COORDINATION OF BENEFIT (COB)  Provider is accountable for COB and required to follow all COB rules as funds under this agreement are those of last resort.  Detroit Xxxxx Mental Health Authority is payers of last resort. Providers must collect payment from all other payers prior to submission of claims.  Claims and encounters for services with COB shall be submitted electronically or on paper as directed by the network with EOB/payment advice from 3rd party payer stapled to claim.  Network claims adjudicators will screen claims encounters for potential COB, and will require providers to pursue uncollected 3rd party payments.  Providers not complying with appropriate COB rules and regulations will be subject to contract compliance standards and protocols.  COB claim must be received within 60 days of receiving payment from primary insurance in order to process claim as Coordination of Benefits.  Primary Payer must be billed within 90 days of date of service. Member Numbers  The DWMHA assigned Member Number must be included on all claims/encounters in the Insurance ID field  For services that require authorization, the authorization number must also be included on the claim form to process. Claims Help  Until further notice, inquiry regarding claims, claims status, and/or adjudication issues contact: xxxxxxxxxx@xxxxx.xxx or call (000) 000-0000 (ask for Claims Unit) Website Help xxx.xxxxx.xxx and xxx.xxxxx.xxx MHWIN ACCESS Subject to the terms and conditions of this Agreement, the Authority hereby grants S e r v i c e Provider non-transferable and non-exclusive access to MHWIN to permit the Service Provider and their office administrators, secretaries and clinicians (collectively...
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Procedure Codes a) All procedure codes listed in this section were reviewed and revised as necessary on June to ensure that the most recent code numbers for currently cov- ered services are used. In the event of any omissions or errors arising as a result of this conversion, coverage will be extended to include those services.
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Procedure Codes.  The current state-defined procedure code set will be required by the system, and must be used in all claims. A copy of acceptable procedure code set can be obtained by contacting xxxxxxxxxx@xxxxx.xxx or call (000) 000-0000 (ask for Claims Unit)  The MDHHS code set is consistently under development by the state. Any additions and changes will be forwarded to the provider as soon as they are available.
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