Upcoming change to message codes for our Enhanced Claim Editor Program

As we previously communicated, AmeriHealth is moving our core business to a new claims processing platform. As part of this transition, the alpha numeric claim message codes associated with the Enhanced Claim Editor Program will change from E8xxx message codes to ECExxxx message codes. 

While the remittance messaging is changing, the core principles of the enhanced editing program remain the same, which is ensuring compliance with correct coding guidelines as endorsed by national and regional industry sources, including but not limited to:

  • Centers for Medicare & Medicaid Services (CMS) standards such as:
    • National Coverage Determinations (NCDs)
    • Local Coverage Determinations (LCDs)
    • Medicare Claims Processing Manual
    • National Correct Coding Initiative (NCCI) Edits
    • Durable Medical Equipment Regional Carries (DMERC) Manual
    • CMS HCPCS LEVEL II Manual coding guidelines
  • American Medical Association (AMA) Current Procedural Terminology (CPT®) coding guidelines
  • ICD-10-CM Official Guidelines for Coding and Reporting
  • Food and Drug Administration (FDA)
  • Nationally recognized specialty societies such as:
    • National Comprehensive Cancer Network (NCCN)
    • American College of Obstetricians and Gynecologists (ACOG)
    • U.S. Preventive Services Task Force (USPSTF)

Look for future articles related to the Enhanced Claim Editor Program and our transition to the new claim processing platform. Visit our dedicated Platform Transition page to stay informed. 

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