July 8th, 2024
Policies receiving their annual review with no changes:
Policies receiving their annual review with the following changes:
Place of service codes
- Added new Place of Service code 66 effective August 1, 2024.
Medicare Indicator “Status B, Status P and Status T” Services Reimbursement
- The Title of the policy was revised to include Status P codes.
- In the Definitions section, added a definition for Status P codes.
- In the Policy section, added the fourth, fifth, and sixth paragraphs to indicate that effective with claim dates of service on and after October 6, 2024, Status P codes will be considered bundled codes and may no longer be separately reimbursable when submitted incident to other physician services on the same date of service but reimbursable when billed with no other physician services on the same date of service by the same provider.
- In the Exceptions section, added the following exceptions to the policy criteria:
- Code G2211 will be considered a bundled service effective with dates of service on and after October 6, 2024
- Code V2520 is exempt from Status P policy criteria and will continue to be reimbursed
- Agency and Supplier providers who submit DME Status P supplies without any other physician services on the same claim are exempt from Status P policy criteria
Modifier 59-Distinct Procedural Service
- In the last paragraph of the Policy section, clarified statement for multiple procedure reductions related policies.
Modifier 90-Reference (Outside)
- In the Policy section, added a statement indicating only one laboratory may bill for a referred laboratory service.
- Added new section “Codes and Coding Guidelines” with drawing fees.
Modifier SU -Procedure Performed in Physician’s Office (Facility and equipment)
- In the Policy section, clarified statement to include examples of facility codes and details to indicate modifier SU is not allowed with POS 11.