Medically Unlikely Edits (MUEs) - ANSWERSnumber of units that can be reported for a service or procedure on the same day
Medicare and Medicaid - ANSWERSMedicare pays first, and Medicaid pays last.
Medicare and TRICARE - ANSWERSTRICARE is secondary
Early and Periodic Screening, Diagnostic, ...
Medically Unlikely Edits (MUEs) - ANSWERSnumber of units that can be reported for a
service or procedure on the same day
Medicare and Medicaid - ANSWERSMedicare pays first, and Medicaid pays last.
Medicare and TRICARE - ANSWERSTRICARE is secondary
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) -
ANSWERSScreening Services/ Vision Services/ Dental Services/ Hearing Services/
Other necessary healthcare services/ Diagnostic services/ Treatment
Prior Authorization - ANSWERSreported in Item 23;
Patient's name (as it appears on the insurance card)
Patient's date of birth
Insured's ID number
CPT®/HCPCS Level II code(s)
ICD-10-CM code(s)
Location where service is performed
Ordering physician
Date of service for the procedure if scheduled
incident-to - ANSWERSsubmit claim under the supervising physician
"those services that are furnished incident-to physician professional services in the
physician's office (whether located in a separate office suite or within an institution) or in
a patient's home"
global package for surgical procedures - ANSWERS0-90 days as determined by the
health plan:
Local infiltration, digital block, or topical anesthesia;
Writing Orders;
treatment in operation room;
postoperative follow-up care
global days - ANSWERSmajor surgeries - 90 days,
minor - 0-10 days
Medicare minor procedure: no pre-operative period; 10-day global period
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