Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server FAQ
Guidance for FAQ regarding Edge Server Operations and Data Submission - Other
Program Area: Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server
Question: Can The Centers for Medicare & Medicaid Services (CMS) provide issuers guidance on how to handle virtual encounters and scheduled phone call claims?
Answer: The only claims eligible for submission for Risk Adjustment (RA) and Reinsurance (RI) consideration, are those that are billed and processed using valid Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes. Claims which do not have a valid CPT or HCPCS code are not eligible for RA & RI consideration.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: November 26, 2014
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