Here are the latest updates to our payment policies. You’ll need to log in to see the policy updates.
- Multiple Diagnostic Cardiovascular Services Reduction
- Multiple Diagnostic Imaging Reductions
- Durable Medical Equipment/Home Medical Equipment: Rental to Purchase
- Modifier 50-Bilateral Procedure
- Modifier 54/55/56-Surgical Care, Post-Op Management Only, Preoperative Management Only
- Modifier 53-Discontinued Procedure
- Modifier 62-Two Surgeons
- Modifier 73-Discontinued ASC Procedure Prior to Administration of Anesthesia
- Modifier 78-Unplanned return to the OR for a Related Procedure
Annual Review; no changes to the policy
- Annual Health Review Visit (G0438/G0439)
Changed the policy archive date to July 1, 2018 to accommodate appeals and reprocessed claims.
- Modifier 22-Increased Procedural Service
Added CROSS REFERENCE to “Modifier 52-Reduced Services” Payment Policy and added a phrase to indicate the modifier could not also be billed with modifier 52-Reduced Service.
- Modifier 52-Reduced Services
Added CROSS REFERENCE to “Modifier 22-Increased Procedural Services” Payment Policy and added a phrase to indicate the modifier could not also be billed with modifier 22- Increased Procedural Service.