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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-060 Biomarker Testing for Autoimmune Rheumatic Disease

Systemic autoimmune rheumatic diseases (SARDs) are a diverse group of conditions that primarily affect the joints, bones, muscle, and connective tissue (AAFP, 2019).

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-066 Prescription Medication and Illicit Drug Testing in the Outpatient Setting

Abuse of both prescription and illicit drugs is extremely common. Drugs of abuse (DOA) may be defined as “a drug, chemical, or plant product that is known to be misused for recreational purposes,” which can include drugs such as pain relievers that have legitimate prescriptions.

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Reimbursement Policy
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Cardiomyopathy, CMS-HCC_V28 Model Updates

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection, along with the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) Version 28 Model Updates, on services submitted to Healthfirst—specifically for the main type of cardiomyopathy.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Opioids Abuse/Use, CMS-HCC_V28 Model Updates

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection, along with the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) Version 28 Model Updates, on services submitted to Healthfirst—specifically for Opioids Abuse/Use.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Cocaine Abuse/Use, CMS-HCC_V28 Model Updates

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection, along with the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) Version 28 Model Updates, on services submitted to Healthfirst—specifically for Cocaine Abuse/Use.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Cannabis Abuse/Use, CMS-HCC_V28 Model Updates

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection, along with the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) Version 28 Updates, on services submitted to Healthfirst—specifically for cannabis abuse/use.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Purpura and Other Hemorrhagic Conditions, CMS-HCC_V28 Model Updates

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection, along with the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) Version 28 Model Updates, on services submitted to Healthfirst—specifically for common types of purpura and other hemorrhagic conditions.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Provider Alerts - Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023
Provider-Identified Overpayments

If a provider determines that Healthfirst has overpaid a claim, the provider shall, within 60 days of discovery, send a refund check made out to Healthfirst PHSP, Inc. in the amount of the overpayment. View the provider alert for details.

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Reimbursement
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-080 Colorectal Cancer Screening

Colorectal cancer (CRC) is the term used to describe the development of cancer in the colon or the rectum.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-079 Coronavirus Testing in the Outpatient Setting

Human coronaviruses, first characterized in the 1960s, are named based on the spiked proteins located on their surface.

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Reimbursement Policy
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Vascular Dementia

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 vascular dementia.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Dementia

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 dementia.

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Clinical Documentation Improvement
  
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