Medical Policy Updates

Reimbursement Policy Update Posted July 27, 2021

Reimbursement Policy Reason for Update
Bundling Guidelines Clarified Allergen Immunotherapy section to include all office visit codes (99202-99215).
Added section Correct Coding Initiative. Clarified Casting Application /Strapping section. Updated Administration Fee for injectable(s) section to require drug or substance code be filed with administration. Added “CPT codes 96372-96379 are considered incidental to evaluation & management services, regardless of modifier usage, when performed in the following places of service (POS): 19, 21, 22, 23, 24, 26, 51, 52, and 61.” Policy notification given 5/18/2021 for effective date 7/28/2021.
Evaluation and Management Services Treatment Rooms with Office Evaluation and Management Services clarification added.
Outpatient code editor (oce) edits Removed OCE exception language from Description and Rationale sections. Notification 5/18/2021 for effective date 7/28/2021.