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Notification of Reimbursement Policy Revisions Effective June 1, 2022 (Posted March 31, 2022) March 31, 2022
Reimbursement PolicyRevision
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 GuidelinesPolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Co-Surgeon, Assistant Surgeon, Team Surgeon and Assistant-at-Surgery GuidelinesPolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Consistency GuidelinesPolicy language updated throughout. Age group definitions updated. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Diagnosis Validity & Code GuidelinesNew policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Evaluation and Management ServicesPolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Facility Billing GuidelinesNew policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Global SurgeryNew policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Guidelines for Global Maternity ReimbursementPolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Immunization GuidelinesPolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Maximum Units of ServicePolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Modifier GuidelinesPolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
NCCI EditingNew policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
ObservationNew policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Once in a LifetimePolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Outpatient Code Editor (OCE) EditsPolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Partial Hospitalization and Intensive Outpatient ProgramsPolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Place of ServiceNew policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Pricing and Adjudication PrinciplesPolicy renamed from “Pricing and Adjudication Principles for Professional Providers” to “Pricing and Adjudication Principles”. Policy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Radiation Therapy ServicesPolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Revenue Codes Requiring Procedure Codes, FacilityNew policy developed. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Split Surgical PackagePolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Status CodesPolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.
Supply and Equipment ReimbursementPolicy language updated throughout. Medical Director approved. Notification on 3/31/2022 for effective date 6/1/2022.

 

 

 

 

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