Molina Healthcare of MI Medicaid Payment Integrity Payment Policies
For Molina Healthcare Active Medicare and Marketplace, Please click the link.
Molina Healthcare Medicare and Marketplace Payment Integrity Payment Policies
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Add-on Coding - Anesthesia Bundling
- Appropriate Level of Care Reimbursement
- Co Surgeon Team Surgeon Professional
- Critical Care Codes when Discharging Home from the Emergency Department
- Decision for Surgery Modifier 57
- Diagnosis Code Coding
- Diagnosis Code Y65 XX
- Emergency EM Codesand Place of Service
- Excludes 1 Note
- DRG Clinical Validation
- General Billing and Coding Policy
- Hospice Value Code 61
- Hydrolyzed Enteral Formula Diagnosis
- ICD-10 First Listed Diagnosis Coding Policy
- ICD-10 Specificity
- Medical Supplies Home Health Consolidated Billingl
- Modifier TC
- Modifier 25
- Modifier 26
- Modifier KX
- MP Facility Bilateralor Anatomical Modifier Use
- Multiple Procedure Payment Reduction
- NCCI PTP with Modifiers
- Non Invasive Abdominal Visceral Vascular Studies
- NPFS Status Indicator T
- Podiatric Q Modifiers
- PT/OT/ST Initial Evaluations
- PT/OT/ST Yearly Limit
- Procedure to Place of Service Policy Professional
- Repeat Procedure Modifiers 76 77
- Status Indicator Flag B Bundled Codes
- Therapy Modifier Coding
- Unlisted Coding
- Unspecified Codes in an Inpatient Setting
- Outpatient Hospital Blood and Blood Products Policy Facility
- Physical Therapy Max Units Per Day
- Appropriate Level of Care Reimbursement
- DRG Clinical Validation
- Facility Emergency Department Evaluation and Management leveling
- Global Surgical Packages for Professional Providers
- Hospice
- Hospital Routine Supplies Services
- High Level Evaluation and Management with Preventive Medicine
- Observation
- Overlapping Room and Borad
- Newborn and NICU
- Psychotherapy Add On with High Level EM
- Readmission
- Sepsis
- Split-Night-Sleep-Study
- After Hours and Weekend Care Professional
- Authorization Review
- Children and Cancer Hospitals Marketplace
- Corrected Claims
- Duplicate Claims
- Fee Schedule
- Interim Hospital Claims
- Marketplace FQHC and RHC
- Member Not Active
- Medically Unlikely Edits
- Paid Amount Exceeded Billed Amount
- Recovery Policy for Billed Units Service Accumulator
- Recovery Policy for CPT to CPT Code
- Recovery Policy for Diagnosis Codes
- Recovery Policy for Revenue to CPT Code Review
- Recovery Policy Variable Discount Payments for Providers
- Semiprivate Vs Private Room
- Urgent Care Marketplace
- Ambulatory Echocardiograph Monitoring
- Autonomic FunctionTesting
- Electrocardiographic EKG or ECG Monitoring Holteror Real Time Monitoring
- Image Guided Radiation Therapy
- Non Invasive Abdominal Visceral Vascular Studies
- Radiology Bone Density
- Colonoscopy and Sigmoidoscopy
- PolysomnographyStudies and Home Sleep Testing