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Documentation & Coding - Practice Guidelines and Tips - 2026

Documentation and Coding: Cardiomyopathy

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection, on services submitted to Healthfirst—specifically for the main type of cardiomyopathy.

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Clinical Documentation Improvement

Documentation & Coding - Practice Guidelines and Tips - 2026

Documentation and Coding: Specified Heart Arrhythmia

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection—specifically for common types of Specified Heart Arrhythmia.

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Clinical Documentation Improvement

Documentation & Coding - Practice Guidelines and Tips - 2026

Documentation and Coding: Diabetes Mellitus

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for Diabetes Mellitus.

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Clinical Documentation Improvement

Documentation & Coding - Practice Guidelines and Tips - 2026

Documentation and Coding: Compression of Brain

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection, on services submitted to Healthfirst—specifically for Compression of Brain (non-Traumatic).

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Clinical Documentation Improvement

Documentation & Coding - Practice Guidelines and Tips - 2026

Documentation and Coding: Chronic Obstructive Pulmonary Disease

This tip sheet is intended to assist providers and coding staff with the documentation and on services submitted to Healthfirst—specifically for Chronic Obstructive Pulmonary Disease (COPD).

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Clinical Documentation Improvement

Documentation & Coding - Practice Guidelines and Tips - 2026

Documentation and Coding: Aspiration Pneumonia

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection, on services submitted to Healthfirst—specifically for types of Aspiration Pneumonia.

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Clinical Documentation Improvement

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-177 CCBHC Provider Billing Guidance – QHP (UB-04 Billing)

This reimbursement policy describes Healthfirst's reimbursement requirements for Certified Community Behavioral Health Clinic (CCBHC) services provided to eligible members enrolled in Healthfirst Qualified Health Plan (QHP) product.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-174 Routine and Non- Routine Foot Care

This reimbursement policy establishes coverage and reimbursement requirements for routine and non-routine foot care services across applicable Healthfirst lines of business.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-170 Additional Office and Outpatient Services Billed with Evaluation and Management (E&M)

This policy outlines Healthfirst's reimbursement methodology for Evaluation and Management (E/M) services and additional office and outpatient services billed on the same date of service.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-117 Fertility and Preservation Services

This reimbursement policy outlines Healthfirst's reimbursement requirements for infertility and fertility preservation services.

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Reimbursement Policy

Pharmacy Resources & Formularies - Provider Resources - 2026

Prior Authorization Pharmacy Medical Benefit Grid

It is the policy of Healthfirst to require prior authorization for medical claims for all medications listed within this document. To learn more, including ways to submit prior authorization, access this resource.

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Authorization

Documentation & Coding - Practice Guidelines and Tips - 2026

Documentation and Coding: Severe Skin Burns

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for common types of Severe Skin Burns.

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Clinical Documentation Improvement

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Documentation and Coding: Cardiomyopathy

Documentation and Coding: Specified Heart Arrhythmia

Documentation and Coding: Diabetes Mellitus

Documentation and Coding: Compression of Brain

Documentation and Coding: Chronic Obstructive Pulmonary Disease

Documentation and Coding: Aspiration Pneumonia

Reimbursement Policy: PO-RE-177 CCBHC Provider Billing Guidance – QHP (UB-04 Billing)

Reimbursement Policy: PO-RE-174 Routine and Non- Routine Foot Care

Reimbursement Policy: PO-RE-170 Additional Office and Outpatient Services Billed with Evaluation and Management (E&M)

Reimbursement Policy: PO-RE-117 Fertility and Preservation Services

Prior Authorization Pharmacy Medical Benefit Grid

Documentation and Coding: Severe Skin Burns

Search

Resource Type

Filter

Year

Sort By

Documentation and Coding: Cardiomyopathy

Documentation and Coding: Specified Heart Arrhythmia

Documentation and Coding: Diabetes Mellitus

Documentation and Coding: Compression of Brain

Documentation and Coding: Chronic Obstructive Pulmonary Disease

Documentation and Coding: Aspiration Pneumonia

Reimbursement Policy: PO-RE-177 CCBHC Provider Billing Guidance – QHP (UB-04 Billing)

Reimbursement Policy: PO-RE-174 Routine and Non- Routine Foot Care

Reimbursement Policy: PO-RE-170 Additional Office and Outpatient Services Billed with Evaluation and Management (E&M)

Reimbursement Policy: PO-RE-117 Fertility and Preservation Services

Prior Authorization Pharmacy Medical Benefit Grid

Documentation and Coding: Severe Skin Burns

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