Smart Edits are not directives, but rather considerations for appropriate claims processing based upon the information submitted on the claim. Medicare will continue to require that all documentation and coverage requirements are met prior to providers making the claim change.
To use the tool, enter the ACE Smart Edit # from/for the claim. On the second screen you will see the ACE Smart Edit Message, description, and any additional information pertinent to your claim. Only ACE Smart Edit #’s listed in the Advance Clinical Editing page table will display.