Notification of Reimbursement Policy Revisions Effective September 18, 2023 (Posted July 18, 2023)
| Reimbursement Policy | Revision |
|---|---|
| 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. |
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