Molina Healthcare of FL Medicaid Billing and Reimbursement Policies

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Molina Healthcare Medicare and Marketplace Payment Integrity Payment Policies- Anesthsia Bundling
- Co Surgeon Team Surgeon Professional
- Discontinued Procedures
- Global Surgical Packages for Professional Providers
- Hydrolyzed Enteral Formula Diagnosis
- Medically Unlikely Edits
- Multiple EM codes for the same provider same date of service
- NPFS Status Indicator T
- Modifier 26
- Modifier KX
- Polysomnography Studies and Home Sleep Testing
- Psychotherapy Add On with High Level EM
- PT/OT Initial Evaluations
- Therapy Modifier Coding
- Unspecified Codes in an Inpatient Setting
- Appropriate Level of Care Reimbursement
- Breast Cancer Genetic Testing Tier 1 vs Tier 2
- Critical Care Codes when Discharging Home from the Emergency Department
- Diagnosis Code Coding
- DRG Clinical Validation
- Excludes 1 Note
- High Level Evaluation and Management with Preventive Medicine
- High Dollar Pharmacy
- Hospital Routine Supplies Services
- Hospice
- ICD-10 Specificity Coding Policy
- ICD-10 First Listed Diagnosis Coding Policy
- Newborn and NICU
- Sepsis
- Split-Night-Sleep-Study
- Overlapping Room and Board
- Optum Pause and Pay
- Observation