Payment Policy Updates August 2017

Here are the latest updates to our payment policies. You’ll need to log in to see the policy updates.

• Manipulation Service
• Medicare Indicator “Status B” Services
• Modifier 25-Significant Service on Same Day as Procedure
• Modifier 58-Staged or Related Procedure during Postoperative Period
• Modifier 91-Repeat Clinical Diagnostic Lab Test
• E&M visit Billed with Preventive Medicine Exam
• Screening Services with E&M service
• Site Specifying Modifier
  Annual review; no changes made to policies
• Modifier JW-Drug amount Discarded/Not Administered to any Patient
  • Added a cross reference to the “National Drug Code Billing Guidelines” policy
  • Added paragraph at bottom of Policy section to add the NDC # from single-use vial or single-use drug packages and where to find that number to include on the claim
• National Drug Code (NDC) Billing Guidelines-Professional Claims
• Added “ME-Milligrams” to the billing criteria as a unit/basis of measurement
• Updated the reference to the Health Insurance Claim For References Instruction Manual used as part of this policy

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