Here are the latest updates to our payment policies. You’ll need to log in to see the policy updates.
September 6, 2018
NDC Billing Guidelines – Facility
NDC Billing Guidelines – Professional
Minor revisions to include supplies and devices which have an assigned NDC# that are subject to the policy billing criteria
Consultation Code Services
Added a label to the “Inpatient and Outpatient Consultations” section in the policy statement. Created a new section “Codes/Coding Guidelines” and moved all of the code descriptions into this section
Contract Exclusions/Disallowed Charges – Inpatient Facility Services
Modified policy title
Elective Abortions – Facility Services
Elective Abortions – Professional Services
Modifier 26 – Professional Component
Modifier GA – Waiver of Liability Issued as required by Payer Policy
Modifier TC – Technical Component
No changes made to all of these policies; all these policies annually reviewed
Serious Adverse Events
Major revision and reorganization of the policy content; revised the presentation of the information for easier reading. Created a new section “Codes/Coding Guidelines” and moved all of the codes and code descriptions into this section
Urgent Care Codes
Revised the policy title and moved the codes that were present in the old title into a newly created section titled “Codes/Coding Guidelines”; added a reference to place of service code 20 which should be submitted with these claims
Physical and Occupational Therapy Services
Pulled out a new code effective 01/01/2018 from the “Therapeutics Procedures” bullet and created a separate bullet for the code since the daily frequency was different from the prior category