Payment Policy Updates May 2019

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

May 2, 2019

The following policies received their annual review without any changes to the policy content:

• Evaluation and Management (E&M) visit Billed with Preventive Medicine Examination
• Manipulation Services
• Modifier 25 – Significant Separately Identifiable Evaluation and Management (E&M) service on same day of Procedure or other service
• Modifier 58 – Staged or Related Procedure or Service by the Same Physician or other qualified Healthcare professional during Postoperative period
• Modifier 91 – Repeat Clinical Diagnostic Laboratory Test

The following policy received its annual review with changes as noted in the Policy:

Hospital or Hospital Readmissions
Clarified throughout the policy that the transferring and the receiving facilities are “acute care inpatient” hospitals.

Back to News