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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 MA Non-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 MA Added Erythropoiesis stimulating agent (ESA), GY, GZ, PI, and Q0 Modifiers.  Added language regarding deceased modifiers and set up of portable x-ray equipment.  Medical Director approved.  Notification on 7/18/2023 for effective date 9/18/2023.
Status Codes MA Added Status Code “I” to Reimbursement Guidelines.  Medical Director approved.  Notification on 7/18/2023 for effective date 9/18/2023.