Payment Policy Updates May 2017

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

    1. Blood Draw (Venipuncture) - 36415
    2. Facility Fees: Clinic Services, Professional Fees and Specialty Services - Treatment Room
    3. Modifier 79 - Unrelated Procedure/Services by Same Provider During Postoperative Period
    4. Modifier SL - State Supplied Vaccine
    5. New and Established Patient Guidelines
    6. Prolonged Services for Labor Management
      Annual reviewed; no changes made
    7. Anesthesia Guidelines
      Added new section in the “Policy” section on the new Moderate Sedation codes and billing guidelines
    8. Anesthesia Modifiers
      In the “Policy” section for the first Modifier AA, clarified that a modifier must be used even by any provider who acts as an anesthesiologist when also performing the surgical procedure
    9. Home Birth Kit (S8415)
      Added additional supplies to the content of the Birth Kit in the “Policy” section

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