Fertility services covered by network EXC_Tattoo Strapping code(s) billed with PT benefit Benefit amount >$100k, <$500 Lesser-of requiring override Medical student taxonomy code Override to member's cost- sharing Dual coverage requiring override Requires per diem pricing Dependent not found EXC_MN_ModSG Gap exception requiring override Vague revenue code NOT 761 or 940 Documentation code(s) >$0 Taxonomy code 246Z00000X Override to Bariatric Surgery benefit Benefit Amount >$500k Newborn: no outreach done AA off for BR that goes to audit Third adjustment High Importance note from 2016 maxTimes1 Newborn: outreach done, pend EXC_Natpath Fertility services covered by network EXC_Tattoo Strapping code(s) billed with PT benefit Benefit amount >$100k, <$500 Lesser-of requiring override Medical student taxonomy code Override to member's cost- sharing Dual coverage requiring override Requires per diem pricing Dependent not found EXC_MN_ModSG Gap exception requiring override Vague revenue code NOT 761 or 940 Documentation code(s) >$0 Taxonomy code 246Z00000X Override to Bariatric Surgery benefit Benefit Amount >$500k Newborn: no outreach done AA off for BR that goes to audit Third adjustment High Importance note from 2016 maxTimes1 Newborn: outreach done, pend EXC_Natpath
(Print)
Fertility services covered by network
EXC_Tattoo
Strapping code(s) billed with PT benefit
Benefit amount >$100k, <$500
Lesser-of requiring override
Medical student taxonomy code
Override to member's cost-sharing
Dual coverage requiring override
Requires per diem pricing
Dependent not found
EXC_MN_ModSG
Gap exception requiring override
Vague revenue code NOT 761 or 940
Documentation code(s) >$0
Taxonomy code 246Z00000X
Override to Bariatric Surgery benefit
Benefit Amount >$500k
Newborn: no outreach done
AA off for BR that goes to audit
Third adjustment
High Importance note from 2016
maxTimes1
Newborn: outreach done, pend
EXC_Natpath
