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Notification of Reimbursement Policy Revisions Effective September 18, 2023 (Posted July 18, 2023)
July 18, 2023
Reimbursement PolicyRevision
Diagnosis Validity MA 

Added “CMS instruction” to correct diagnostic coding in Reimbursement Guidelines.  Medical Director Approved.  Notification on 7/18/2023 for effective date 9/18/2023.

Drug and Biologicals MA

Modifier JZ added to Billing and Coding.  Instruction for drugs with multiple administration routes added to Reimbursement Guidelines.  Medical Director approved.  Notification on 7/18/2023 for effective date 9/18/2023.

Global Surgery MANon-physician practitioners reimbursement of a Major Procedure (90 day) language added to Reimbursement Guidelines.  Medical Director approved.  Notification on 7/18/2023 for effective date 9/18/2023.
Modifier Guidelines MAAdded Erythropoiesis stimulating agent (ESA) modifiers, deceased modifiers, Modifier PI, and X-Ray Transportation.  Medical Director Approved.  Notification on 7/18/2023 for effective date 9/18/2023.
Status Codes MAAdded Status Code “I” to Reimbursement Guidelines.  Medical Director approved.  Notification on 7/18/2023 for effective date 9/18/2023.

 

 

 

 

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