Smart Edits

Smart Edits is a claims optimization tool that identifies billing errors within a claim and allows care providers the opportunity to review and repair problematic claims. These courses provide more details on each of the edits.

Smart Edits 101open_in_new

Types of Smart Editsopen_in_new

Add-on Codes Smart Editopen_in_new

Always Therapy Smart Editsopen_in_new

Anatomic Modifiers for Surgical Procedures (uAMSP)open_in_new

Bundling/Unbundling Smart Editsopen_in_new

Clinical Laboratory Improvement Amendments (CLIA)open_in_new

Coordination of Benefits (COB) Smart Editopen_in_new

Discarded Drug Modifieropen_in_new

Evaluation and Management Level Review/Reconsideration Smart Editsopen_in_new

Expanded Exact Match Duplicate Smart Editsopen_in_new

ICD-10 CM Excludes 1 Code Pairsopen_in_new

Inappropriate Modifieropen_in_new

Inappropriate Primary Diagnosis Coding (IPDDN)open_in_new

Invalid Procedure Diagnosis Smart Editsopen_in_new

Laboratory Smart Editsopen_in_new

LCD Part B Missing or Invalid Diagnosisopen_in_new

Missing Taxonomy Code (Texas Medicaid Only)open_in_new

Molecular Test Z-Code Program (DEX)open_in_new

National Drug Code (NDC)open_in_new

New Patient Visit Smart Editsopen_in_new

Non-Covered Codes open_in_new

Ohio Nextgen Wrong Payer IDopen_in_new

Ordering and Referring Smart Editsopen_in_new

Preventive Service Included in Primary Procedureopen_in_new

Professional/Technical Component Based on Place of Service Smart Editsopen_in_new

Replacement Code Denialsopen_in_new

Telehealth Smart Editsopen_in_new

Vitamin D Smart Editsopen_in_new