Effective December 1, 2023: Revised Payment Policy - Code Editing Overview
Date: 10/02/23
Superior HealthPlan presents a revised payment policy to communicate an update to incorporate ICD-10-CM Official Guidelines for Coding and Reporting in Edit Sources utilized in Code Editing. As a result, the following policy has been revised, and is posted on Superior’s Clinical, Payment and Pharmacy Policies webpage for review, prior to its implementation:
POLICY | EFFECTIVE DATE | APPLICABLE PRODUCTS | NEW POLICY OVERVIEW OR UPDATED POLICY REVISIONS |
|---|---|---|---|
TX.CC.PP.011* Code Editing Overview | December 1, 2023 | Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP, Health Insurance Marketplace (Ambetter from Superior HealthPlan, Medicare (Wellcare By Allwell[ HMO,HMO D-SNP) | Existing policy CC.PP.011 has been updated to incorporate reference to the ICD-10-CM Official Guidelines for Coding and Reporting as an Edit Source in Code Editing, which incorporates guidelines for “Selection of Principal Diagnosis.”
|
* REPLACES Current Policy CC.PP.011 - Code Editing Overview
To review all clinical payment or payment policies, please visit Superior’s Clinical, Payment and Pharmacy Polices webpage.
For questions or additional information, please contact Superior Provider Services at:
- 1-877-391-5921 (Medicaid [STAR, STAR Health, STAR Kids, STAR+PLUS], CHIP, Wellcare By Allwell [HMO, HMO D-SNP])
- 1-877-687-1196 (Ambetter from Superior HealthPlan)