Correct Coding Reminder

As a normal business practice, claims are subject to payment edits that are updated at regular intervals and generally based on Centers for Medicare & Medicaid Services (CMS) guidelines, specialty society guidelines, evaluation of drug manufacturers’ package label inserts, and the National Correct Coding Initiative (NCCI).

Procedure and diagnosis codes undergo annual and quarterly revision by CMS, the American Medical Association, and NCCI. As these revisions are made public, Tufts Health Plan will update its system to reflect these changes during the third calendar quarter of 2010.

Payment policies will be updated to reflect the addition and replacement of procedure codes, where applicable.

August 1, 2010