Harvard Pilgrim regularly enhances our claims editing platform to ensure that our policies are more consistent with national correct coding standards and policies, which focus on areas such as:
- Bundling edits including the National Correct Coding Initiative (NCCI)
- Modifier usage
- Global surgery period
- Add on code usage
- Age appropriateness
Updates occur regularly, and additional automated claims edits will take effect beginning on May 1, 2016. As always, if you have any questions about a claim, please contact the Provider Service Center at 800-708-4414.