Payment Policy Updates July 2022

  • June policy updates

    The following policies received their annual review with no changes:

    The following policies received their annual review with changes noted below:

    Modifier TH – obstetrical treatment/services
    Minor clarification to paragraphs two and three in the policy statement. Removed code 99201 which was deleted January 1, 2021. Updated the description for code 99211 in code/coding guideline section.

    Multiple deliveries/births
    Added clarification on the correct use of modifier 22 to represent additional work required for additional deliveries.

    Multiple surgical reductions
    Additional clarification added to paragraph three in the policy indicating only those applicable codes will be subject to multiple procedure reduction.

    Physical therapy and occupational therapy assistant modifiers: CQ and CO
    Created a separate section in the policy for required “Plan of Care Modifiers.”

    Physical, occupational and speech therapy services
    Policy title revised to include speech therapy. Removed from the policy code 97127 which was terminated effective December 31, 2019. Added a new section in the policy for speech therapy services. Effective with claims processed on and after August 15, 2022, a plan of care modifier (GN/GO/GP) must be appended to applicable therapy services. Added speech therapy procedure codes and descriptions to the codes/coding guidelines section.

    Prolonged services for labor management
    Clarified the first paragraph in the policy section when prolonged services procedure codes are billed for labor management by a provider who does not perform the delivery.

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