Palmetto GBA
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Jurisdiction 1 Part B
Medical Review

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E/M Comparative Billing Reports: Peer Code Comparison July through December 201205/13/2013
Completion of Prepayment Service Specific Complex Review for CPT Code 95165: Professional Services for Allergen Immunotherapy in Northern and Southern California05/09/2013
Completion of Prepayment Service Specific Complex Review for CPT Code 99214: Evaluation and Management (E/M) Established Patient Office Visit Services in Hawaii04/15/2013
Completion of Prepayment Service Specific Complex Review for CPT Code 99214: Evaluation and Management (E/M) Established Patient Office Visit Services in Nevada04/15/2013
Completion of Prepayment Service Specific Complex Review for CPT Code 99214: Evaluation and Management (E/M) Established Patient Office Visit Services in Northern California04/15/2013
Completion of Prepayment Service Specific Complex Review for CPT Code 99214: Evaluation and Management (E/M) Established Patient Office Visit Services in Southern California04/15/2013
Completion of Prepayment Service Specific Complex Review for CPT Code 99310: Subsequent Nursing Facility Care Services in All Regions of J103/07/2013
Completion of Prepayment Service Specific Complex Review for CPT Code 99309: Subsequent Nursing Facility Care Services in All Regions of J103/06/2013
J1 Part B Medical Review Top Denial Reason Codes03/06/2013
Corrective Action Plan (CAP) Guidelines for Provider Documentation02/21/2013
J1 Part B Service Specific Complex Pre-Payment Review Notice for CPT Code 99204: E/M Initial Office Visit Services for Provider Specialties 01, 04, 08, 18, 25, 48 and 66 in Northern California and Southern California01/10/2013
J1 Part B Service Specific Complex Pre-Payment Review Notice for CPT Code 99204: E/M Initial Office Visit Services for Provider Specialty Codes 11 and 18 in Nevada, Hawaii and the Islands01/10/2013
J1 Part B Service Specific Complex Pre-Payment Review Notice for CPT Code 99205: E/M Initial Office Visit Services for Nevada, Hawaii and the Islands01/10/2013
J1 Part B Service Specific Complex Pre-Payment Review Notice for CPT Code 99205: E/M Initial Office Visit Services for Provider Specialties 06, 08, 11, 13, 48 and 83 in Northern California and Southern California01/10/2013
Completion of Prepayment Service Specific Complex Review for CPT Code 95024: Intracutaneous Tests with Allergenic Extracts in Southern California01/08/2013
Completion of Prepayment Service Specific Complex Review for CPT Code 95165: Professional Services for Allergen Immunotherapy in Southern California and Northern California01/08/2013
J1 Part B Service Specific Probe Review Notice for CPT Codes 73221, 73721 and 70551: Advanced Imaging Services01/07/2013
Medical Review Progressive Corrective Action (PCA) Process12/19/2012
Responding to Therapy Cap Additional Documentation Requests (ADRs)12/11/2012
Completion of Prepayment Service Specific Complex Review for CPT Code 99214: Evaluation and Management (E/M) Established Patient Office Visit Services in Nevada11/06/2012
Completion of Prepayment Service Specific Complex Review for CPT Code 99214: Evaluation and Management (E/M) Established Patient Office Visit Services in Hawaii11/05/2012
Completion of Prepayment Service Specific Complex Review for CPT Code 99214: Evaluation and Management (E/M) Established Patient Office Visit Services in Southern California11/01/2012
Completion of Prepayment Service Specific Complex Review for CPT Code 99214: Evaluation and Management (E/M) Established Patient Office Visit Services in Hawaii and the Islands10/31/2012
Completion of Prepayment Service Specific Complex Review for CPT Code 99214: Evaluation and Management (E/M) Established Patient Office Visit Services in Northern California10/31/2012
Completion of Prepayment Service Specific Complex Review for CPT Code 95024, Intracutaneous Tests with Allergenic Extracts10/03/2012
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last updated on 5/01/2013
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