Medical Policy Updates

Reimbursement Policy Update for June 1, 2022

Reimbursement Policy Revision
Add-On Codes New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Anesthesia, Professional And Facility New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Bundling Guidelines New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Co-Surgeon, Assistant Surgeon, Team Surgeon And Assistant-At-Surgery Guidelines New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Consistency Guidelines New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Diagnosis Validity & Code Guidelines New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Evaluation And Management Services New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Facility Billing Guidelines New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Global Surgery New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Immunization Guidelines New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Maximum Units Of Service New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Multiple Cardiovascular, Radiology, And Ophthalmology Services New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Modifier Guidelines New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
NCCI Editing New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Observation New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Once In A Lifetime New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Outpatient Code Editor (OCE) Edits New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Partial Hospitalization And Intensive Outpatient Programs New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Place Of Service New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Preadmission And Preoperative Services New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Pricing And Adjudication Principles New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Revenue Codes Requiring Procedure Codes, Facility New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Split Surgical Package New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Status Codes New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Supply And Equipment Reimbursement New policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.