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Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Morbid Obesity

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 Morbid Obesity.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Heart Failure

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 coding Heart Failure.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2025
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
  
Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Deep Vein Thrombosis

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 Deep Vein Thrombosis (DVT).

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Best Practices for Documentation

This tip sheet is intended to assist providers and coding staff with Best Practices for Documentation and ICD-10-CM selection.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Anorexia Nervosa and Bulimia Nervosa

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 Anorexia Nervosa and Bulimia Nervosa.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Acute and Chronic Cor Pulmonale

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 Cor Pulmonale.

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Clinical Documentation Improvement
  
Provider Alerts - Claims & Billing - Practice Guidelines and Tips - 2025
Clear Claim Connection (C3) SSO Now Available on Availity Essentials

Effective March 2025, the Clear Claim Connection™ (C3) tool is no longer available on Healthfirst’s legacy provider portal (https://hfproviderportal.org).

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Administration
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-078 Telemedicine

This policy outlines the guidelines for telemedicine and telehealth services eligible for reimbursement by Healthfirst.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-106 e-Consult Visits

This document describes the eConsult visit policy Healthfirst Utilization Management follows when reimbursing for services provided by contracted providers.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-127 Canalith Repositioning Procedure

Healthfirst adheres to the Centers for Medicare & Medicaid Services (CMS) guidelines for Canalith Repositioning Procedures. This policy outlines the reimbursement criteria and procedure for the CPT code 95992, which is designated for the therapeutic management of benign paroxysmal positional vertigo (BPPV).

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-131 Psychological and Neuropsychological Testing

Effective May 1, 2025, Healthfirst will implement a new reimbursement policy for Psychological-Neuropsychological testing. This policy is aligned with Local Coverage Determination L34520 and Local Coverage Article A57780 R-10-01-2024 (Jurisdiction N).

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Reimbursement Policy
  
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