Molina Healthcare of MI Medicaid 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