Molina Healthcare of OH Medicaid Payment Integrity Payment Policies
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Molina Healthcare Medicare and Marketplace Payment Integrity Payment Policies
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Add-on Coding - Co Surgeon Team Surgeon Professional
- Critical Care Codes when Discharging Home from the Emergency Department
- Decision for Surgery Modifier 57
- Diagnosis Code Coding
- Global Surgical Packages for Professional Providers
- Hydrolyzed Enteral Formula Diagnosis
- ICD-10 First Listed Diagnosis Coding Policy
- ICD-10 Specificity
- Inpatient services billed on Outpatient bill types
- Medically Unlikely Edits
- Modifier 25
- Modifier 26
- Modifier KX
- Modifier TC
- Multiple EM codes for the same provider same date of service
- NCCI PTP with Modifiers
- Reduced Services and Discontinued Procedures
- Therapy Modifier Coding
- Unspecified Codes in an Inpatient Setting
- Appropriate Level of Care Reimbursement
- Breast Cancer Genetic Testing Tier 1 vs Tier 2
- DRG Clinical Validation
- Excludes 1 Note
- Facility Emergency Department Evaluation and Management leveling
- Hospital Routine Supplies Services
- Optum Pause and Pay
- Newborn and NICU
- NF Ventilator Pre-Payment Medical Necessity Review
- Observation
- High Level Evaluation and Management with Preventive Medicine
- Psychotherapy Add On with High Level EM
- Readmission
- Sepsis
- Split-Night-Sleep-Study
- After Hours and Weekend Care Professional
- Authorization Review
- Cross-Departmental Recovery Policy
- Corrected Claims
- Duplicate Claims
- Fee Schedule
- General Billing and Coding Policy
- Interim Hospital Claims
- Medical Supplies Home Health Consolidated Billingl
- MemberNotActive12162024l
- Multiple Procedure Payment Reduction
- 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
- Ambulatory Echocardiograph Monitoring
- Aortography and Peripheral Angiography
- Autonomic FunctionTesting
- CT Computed Tomography of the Abdomen and Pelvis
- Electrocardiographic EKG or ECG Monitoring Holteror Real Time Monitoring
- Image Guided Radiation Therapy
- Non Invasive Abdominal Visceral Vascular Studies
- Pulmonary Function Testing
- Radiology Bone Density
- Radiology for chest