Codes
COSMOS Screens
PIs
Reviews
A Little Bit of Everything
100

98941 is an example of this type of code

What is a CPT code?

100

This COSMOS screen is where we look up division specific member timelines 

What is the GI101?

100

This PI is used to verify the correct member is selected on our claim

What is the member number PI?

100

This review verifies timely filing

What is the 031 review?

100

This is the technical name of the hospital hard copy

What is a UB-04?

200
M54.51 is an example of this type of code

What is an ICD-10 code?

200

This COSMOS screen is the starting point for provider selection where we enter our FedID and NPI

What is the GI205?

200

This PI is used to verify the correct provider has been selected on our claim

What is the provider selection PI?

200

This review verifies duplicate claims

What is the 022/075/711 reviews?

200

This is the hot key to open multiple COSMOS screens in the morning

What is Ctl + Spacebar

300

A two-digit addition to the end of a procedure code with a separate definition is known as this

What is a modifier?


300

This COSMOS screen shows the provider's office address

What is the PS308/PS304

300

This PI is used to verify if the copay and/or deductible has been applied correctly to our claim

What is the Copay and Deductibles PI?

300

This review prices outpatient claims per Webstrat

What is the 473 review?

300

This macro launches Skynet

What is Alt + Shift + Enter (keypad)

400

This two-digit numeric code can be found in CPA and indicates where the member's services were rendered

What is the place of service (POS)?

400

This COSMOS screen shows the provider's Medicare ID

What is the PS304/PS510

400

This PI is used to verify copays for Skilled Nursing Facility (SNF) Stays

What is the 230?

400

This review has us process corrected billing claims

What is the 7009 review?

400

True or False: If you have a line denied in CPA prior to your Webstrat review, you should leave it in Webstrat when you price it per the 473 review.  

False - All previously denied lines should be removed before pricing on the 473 review. 

500

This three-digit code is submitted on the hard copy and defines the category of services performed by the provider. 

What is a revenue code? 

500

This COSMOS screen is used to verify denials on a claim

What is the TB208?

500

This PI has three total reviews that it covers and has us verify if prior authorization is required for the codes submitted by the provider

What is the 7000, 7001, 7002 PI? 

500

This review is for non-contracted (non-par) providers and requires that they submit notification/authorization

What is the 091 review?

500

When reviewing denials per the TB208 COSMOS screen, this document should also always be opened to confirm whether the denial is member or provider liability

What is the TB208 spreadsheet?

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