Risk Adjustment for EDS and RAPS User Group - January 19, 2017

Slides 5-9 - EDFES Edits, Top EDFES Edits in 2015, 2016
Slides 7-8 - EDFES Edits, Edit 255
Slide 9 - EDFES Edits, Edit 509
Slide 11 - HCPCS S-Codes and G-Codes, EDFES
Slide 12 - Advanced Billing Concept (ABC) Codes, EDFES
Slide 13 - EDFES Edits, Edit 145
Slide 13 - EDFES Edits, Edit 747
Slide 14 - EDFES Edits, Edit 453
Slides 16-22 - EDPS Edits, Top EDPS Edits in 2014, 2015, 2016, Broken out by INST, DME, and PROF, and Header vs Line
Slides 23-29 - EDPS Edits, Edit 98325, Includes edit descriptions, and analysis of edits, listing on MAO-001, prevention tips, bypass conditions
Slide 31 - EDPS Edits, Edit 00800
Slide 32 - Report Restoration, Timelines by report
Slide 33 - Claim Adjudication Disposition, EDRs denied or rejected by submitter, Guidance for submitting accepted, rejected, and denied claims/EDRs
Slides 34-40 - MAO-004, Technical Refinements to the MAO-004, Description of refinements to Phase II of MAO-004 report; checklist for MAO-002 and MAO-004 reports - before sending ICNs to CMS
Slides 41-48 - MOR, Overview of models in PY 2016 and 2017, Description of HCC used in each model, introduction of new record types

Last Updated: 01/19/2017

Table of Contents