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Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Metastatic Cancer/ Secondary Malignant Neoplasm

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 Metastatic Cancer/Secondary Malignant Neoplasm.

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Clinical Documentation Improvement
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Book 4: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers

(Conference Book 4) Virtual Continuing Medical Education (CME) Conference: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers This event is jointly offered by Healthfirst and SUNY Downstate Health Sciences University.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Book 3: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers

(Conference Book 3) Virtual Continuing Medical Education (CME) Conference: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers This event is jointly offered by Healthfirst and SUNY Downstate Health Sciences University.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Book 2: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers

(Conference Book 2) Virtual Continuing Medical Education (CME) Conference: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers This event is jointly offered by Healthfirst and SUNY Downstate Health Sciences University.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Book 1: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers

(Conference Book 1) Virtual Continuing Medical Education (CME) Conference: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers This event is jointly offered by Healthfirst and SUNY Downstate Health Sciences University.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Panel 2: Spring 2023 Provider Symposium

(Panel 2 booklet) The theme for the May 19, 2023 Healthfirst Spring Symposium is "Artificial Intelligence in Healthcare: Improving Health Outcomes and Advancing Equity with New Tools."

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Panel 1: Spring 2023 Provider Symposium

(Panel 1 booklet) The theme for the May 19, 2023 Healthfirst Spring Symposium is "Artificial Intelligence in Healthcare: Improving Health Outcomes and Advancing Equity with New Tools."

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Agenda and Keynote: Spring 2023 Provider Symposium

(Agenda and Keynote booklet) The theme for the May 19, 2023 Healthfirst Spring Symposium is "Artificial Intelligence in Healthcare: Improving Health Outcomes and Advancing Equity with New Tools."

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Provider Events
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023
Reimbursement Policy: PO-RE-071v1 Modifier Usage

Modifiers have been defined by the American Medical Association (AMA) and adopted by the Centers for Medicare and Medicaid Services (CMS) to provide additional information regarding the services rendered.

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Reimbursement Policy
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2023
Authorization Requirement Update for Vision Services

Effective May 1, 2023, Healthfirst no longer requires authorization for selected vision services.

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Authorization
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023
Reimbursement Policy: PO-RE-075v1 Laboratory Procedures

To be considered for reimbursement, all outpatient laboratory claims should be submitted in accordance with: - AMA CPT and HCPCS coding and ICD-10 diagnosis coding guidelines - Other laboratory and pathology coding guidelines - All applicable regulatory guidelines This policy outlines additional requirements beyond the guidelines listed above that are required for reimbursement. Note that these guidelines are reviewed and updated periodically.

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Reimbursement Policy
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2023
Introducing Coding Validation from Cotiviti

Effective Sept. 1, 2023, consistent with the recommendations of the Office of Inspector General and the Centers for Medicare & Medicaid Services, Healthfirst will implement Cotiviti’s Coding Validation, an enhanced program based on nationally sourced guidelines regarding modifier usage.

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Reimbursement
  
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