CPT copyright 2010 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.The following Q&A comes from ...
CMS has published online most of the edits utilized in its Medically Unlikely Edit (MUE) program to improve the accuracy of claims payments for Medicare Part B services. These edits, applied during ...
Navigating Aetna's Expanded Claim Edits: What Providers Need To Know and Do Before September 1, 2025
Aetna recently announced that effective September 1, 2025, its Claim and Code Review Program (CCRP) will expand to include additional claim coding edits for all commercial, Medicare, and Student ...
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CMS issues MDS 3.0 updates ahead of FY2026 rollout
The Centers for Medicare & Medicaid Services (CMS) has finalized updates to MDS 3.0 technical specifications, item sets, and the RAI User’s Manual for FY2026, effective October 1, 2025. These include ...
As the 2026 fiscal year settles in, skilled nursing facilities are facing a pivotal moment in reimbursement accuracy: the CMS Final Rule has finalized significant updates to PDPM ICD-10 mappings and ...
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