Clinical Payment and Coding Policy - Archived Documents
Anesthesia Clinical Payment and Coding Information | Policy Number | Effective Date | End Date |
---|---|---|---|
Anesthesia Clinical Payment and Coding Information ![]() |
CPCP010 | 07/20/2020 | 12/28/2021 |
Anesthesia Clinical Payment and Coding Information ![]() |
CPCP010 | 02/01/2019 | 07/19/2020 |
Anesthesia Clinical Payment and Coding Information ![]() |
CPCP010 | 10/01/2018 | 01/31/2019 |
Applied Behavior Analysis | Policy Number | Effective Date | End Date |
Applied Behavior Analysis ![]() |
CPCP011 | 03/03/2021 | 02/28/2021 |
Applied Behavior Analysis for Autism Spectrum Disorders ![]() |
CPCP011 | 07/10/2020 | 03/02/2021 |
Applied Behavior Analysis for Autism Spectrum Disorders ![]() |
CPCP011 | 06/18/2019 | 07/09/2020 |
Applied Behavior Analysis for Autism Spectrum Disorders ![]() |
CPCP011 | 06/01/2018 | 06/17/2019 |
Co-Surgeon/Team Surgeon Modifiers | Policy Number | Effective Date | End Date |
Co-Surgeon/Team Surgeon Modifiers ![]() |
CPCP009 | 10/15/2020 | 10/31/2021 |
Co-Surgeon/Team Surgeon Modifiers ![]() |
CPCP009 | 09/03/2019 | 10/14/2020 |
Co-Surgeon/Team Surgeon Modifiers ![]() |
CPCP009 | 10/15/2018 | 09/02/2019 |
Co-Surgeon/Team Surgeon Modifiers ![]() |
CPCP009 | 06/28/2018 | 10/14/2018 |
Coordinated Home Care/Private Duty Nursing | Policy Number | Effective Date | End Date |
Coordinated Home Care /Private Duty Nursing Policy Guideline ![]() |
CPCP005 | 10/15/2020 | 11/30/2021 |
Coordinated Home Care /Private Duty Nursing Policy Guideline ![]() |
CPCP005 | 01/01/2020 | 10/14/2020 |
Coordinated Home Care Policy ![]() |
CPCP005 | 02/15/2019 | 12/31/2019 |
Chiropractic Services | Policy Number | Effective Date | End Date |
Chiropractic Services ![]() |
CPCP016 | 10/15/2020 | 01/13/2022 |
Chiropractic Services ![]() |
CPCP016 | 12/03/2019 | 10/14/2020 |
Chiropractic Services ![]() |
CPCP016 | 10/25/2019 | 12/02/2019 |
Chiropractic Services ![]() |
CPCP016 | 09/01/2018 | 10/24/2019 |
Corrected Claim Submissions | Policy Number | Effective Date | End Date |
Corrected Claim Submissions ![]() |
CPCP025 | 01/15/2020 | 08/14/2020 |
Drug Testing Clinical Payment and Coding Policy | Policy Number | Effective Date | End Date |
Drug Testing Clinical Payment and Coding Policy ![]() |
CPCP020 | 12/28/2020 | 08/31/2021 |
Drug Testing Clinical Payment and Coding Policy ![]() |
CPCP020 | 05/01/2020 | 12/27/2020 |
Drug Testing Clinical Payment and Coding Policy ![]() |
CPCP020 | 04/01/2019 | 04/30/2020 |
Emergency Department Evaluation and Management (E/M) Services Coding – Facility Services | Policy Number | Effective Date | End Date |
Emergency Department Evaluation and Management (E/M) Services Coding – Facility Service ![]() |
CPCP003 | 02/25/2021 | 03/19/2022 |
Emergency Department Evaluation and Management (E/M) Services Coding – Facility Services ![]() |
CPCP003 | 01/25/2020 | 02/24/2021 |
Facility & Professional Coding of Evaluation and Management of Emergency Department Services ![]() |
CPCP003 | 03/01/2019 | 01/24/2020 |
Evaluation and Management of Emergency Department Coding ![]() |
CPCP003 | 06/01/2018 | 02/28/2019 |
Evaluation and Management of Emergency Department Coding ![]() |
CPCP003 | 7/24/2017 | 05/31/2018 |
Evaluation and Management (E/M) Coding – Professional Provider Services | Policy Number | Effective Date | End Date |
Evaluation and Management (E/M) Coding – Professional Provider Services ![]() |
CPCP024 | 01/01/2021 | 04/30/2022 |
Evaluation and Management (E/M) Coding – Professional Provider ![]() |
CPCP024 | 01/01/2021 | 01/01/2021 |
Evaluation and Management (E/M) Coding – Professional Provider ![]() |
CPCP024 | 01/25/2020 | 12/31/2020 |
Facility & Professional Coding of Evaluation and Management of Emergency Department Services ![]() |
CPCP003 | 03/01/2019 | 01/24/2020 |
Evaluation and Management of Emergency Department Coding ![]() |
CPCP003 | 06/01/2018 | 02/28/2019 |
Evaluation and Management of Emergency Department Coding ![]() |
CPCP003 | 7/24/2017 | 05/31/2018 |
Global Surgical Package | Policy Number | Effective Date | End Date |
Global Surgical Package ![]() |
CPCP014 | 08/15/2021 | 05/25/2021 |
Global Surgical Package ![]() |
CPCP014 | 06/18/2019 | 08/14/2020 |
Global Surgical Package ![]() |
CPCP014 | 06/28/2018 | 06/17/2019 |
Hernia Repair | Policy Number | Effective Date | End Date |
Hernia Repair ![]() |
CPCP012 | 09/15/2020 | 09/30/2021 |
Hernia Repair ![]() |
CPCP012 | 06/18/2019 | 09/14/2020 |
Hernia Repair ![]() |
CPCP012 | 06/28/2018 | 06/17/2019 |
Home Infusion | Policy Number | Effective Date | End Date |
Home Infusion ![]() |
CPCP019 | 10/10/2020 | 12/20/2021 |
Home Infusion ![]() |
CPCP019 | 01/01/2020 | 10/09/2020 |
Implant Payment and Coding Policy | Policy Number | Effective Date | End Date |
Implant Payment and Coding Policy ![]() |
CPCP007 | 08/01/2019 | 10/09/2020 |
Implant Payment and Coding Policy ![]() |
CPCP007 | 11/15/2018 | 07/31/2019 |
Implant Payment and Coding Policy ![]() |
CPCP007 | 10/01/2018 | 11/14/2018 |
Implant Payment and Coding Policy ![]() |
CPCP007 | 11/15/2017 | 09/30/2018 |
Increased Procedural Services (Modifier 22) | Policy Number | Effective Date | End Date |
Increased Procedural Services (Modifier 22) ![]() |
CPCP013 | 07/20/2020 | 08/11/2021 |
Increased Procedural Services (Modifier 22) ![]() |
CPCP013 | 02/20/2019 | 07/19/2020 |
Increased Procedural Services (Modifier 22) ![]() |
CPCP013 | 06/27/2018 | 02/19/2019 |
Inpatient Readmissions | Policy Number | Effective Date | End Date |
Inpatient Readmissions ![]() |
CPCP027 | 06/20/2020 | 12/31/2021 |
Inpatient/Outpatient Unbundling Policy | Policy Number | Effective Date | End Date |
Inpatient/Outpatient Unbundling Policy ![]() |
CPCP002 | 03/18/2021 | 01/13/2022 |
Inpatient/Outpatient Unbundling Policy ![]() |
CPCP002 | 10/15/2019 | 03/17/2021 |
Inpatient/Outpatient Unbundling Policy ![]() |
CPCP002 | 08/01/2019 | 10/14/2019 |
Inpatient/Outpatient Unbundling Policy ![]() |
CPCP002 | 11/15/2018 | 07/31/2019 |
Inpatient/Outpatient Unbundling Policy ![]() |
CPCP002 | 10/01/2018 | 11/14/2018 |
Inpatient Unbundling Policy ![]() |
CPCP002 | 07/24/2017 | 09/30/2018 |
Laboratory Panel Billing | Policy Number | Effective Date | End Date |
Laboratory Panel Billing ![]() |
CPCP021 | 06/10/2021 | 11/09/2021 |
Laboratory Panel Billing Guideline ![]() |
CPCP021 | 09/01/2020 | 06/09/2021 |
Laboratory Panel Billing Guideline ![]() |
CPCP021 | 07/18/2019 | 08/31/2020 |
Medical Record Documentation Guideline | Policy Number | Effective Date | End Date |
Medical Record Documentation Guideline ![]() |
CPCP029 | 07/12/2021 | 11/30/2021 |
Medical Record Documentation Guideline ![]() |
CPCP029 | 03/10/2020 | 07/11/2021 |
Medical Record Documentation Guideline ![]() |
CPCPG01 | 11/01/2019 | 03/09/2020 |
Medical Record Documentation Guideline ![]() |
CPCPG01 | 04/01/2019 | 10/31/2019 |
Modifier Reference Guidelines | Policy Number | Effective Date | End Date |
Modifier Reference Guideline ![]() |
CPCP023 | 07/15/2021 | 07/15/2021 |
Modifier Reference Guideline ![]() |
CPCP023 | 07/10/2020 | 07/14/2021 |
Modifier Reference Guideline ![]() |
CPCP023 | 04/01/2019 | 07/09/2020 |
Multiple Surgical Procedures | Policy Number | Effective Date | End Date |
Multiple Surgical Procedures ![]() |
CPCP015 | 08/07/2020 | 11/30/2021 |
Multiple Surgical Procedures ![]() |
CPCP015 | 06/22/2019 | 11/09/2020 |
Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement Policy | Policy Number | Effective Date | End Date |
Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement Policy ![]() |
CPCP004 | 04/05/2021 | 01/13/2022 |
Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement Policy ![]() |
CPCP004 | 06/15/2020 | 04/04/2021 |
Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement Policy ![]() |
CPCP004 | 07/15/2019 | 06/14/2020 |
Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement Policy ![]() |
CPCP004 | 06/01/2018 | 07/14/2019 |
Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement Policy ![]() |
CPCP004 | 10/01/2017 | 05/31/2018 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) | Policy Number | Effective Date | End Date |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 08/15/2021 | 04/14/2022 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 08/15/2021 | 01/31/2022 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 08/15/2021 | 08/15/2021 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 07/01/2021 | 08/14/2021 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 05/15/2021 | 06/30/2021 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 04/01/2021 | 05/14/2021 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 03/01/2021 | 03/31/2021 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 03/01/2021 | 03/01/2021 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 01/01/2021 | 02/28/2021 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 12/01/2020 | 12/31/2020 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 12/01/2020 | 12/01/2020 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 09/01/2020 | 11/30/2020 |
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) ![]() |
CPCP028 | 09/01/2020 | 09/01/2020 |
Observation Services Tool For Applying MCG Care Guidelines | Policy Number | Effective Date | End Date |
Observation Services Tool for Applying MCG Care Guidelines ![]() |
CPCP001 | 06/15/2020 | 11/03/2021 |
Observation Services Tool for Applying MCG Care Guidelines ![]() |
CPCP001 | 08/01/2019 | 06/14/2020 |
Observation Services Tool for Applying MCG Care Guidelines ![]() |
CPCP001 | 09/01/2018 | 07/31/2019 |
Observation Services Tool for Applying MCG Care Guidelines ![]() |
CPCP001 | 11/01/2016 | 08/31/2018 |
Pneumatic Compression Devices – Outpatient Use | Policy Number | Effective Date | End Date |
Pneumatic Compression Devices – Outpatient Use ![]() |
CPCP022 | 10/01/2020 | 04/11/2022 |
Pneumatic Compression Devices – Outpatient Use ![]() |
CPCP022 | 11/01/2019 | 09/30/2020 |
Point-of-Care Ultrasound Examination Policy | Policy Number | Effective Date | End Date |
Point-of-Care Ultrasound Examination Guideline ![]() |
CPCP030 | 09/15/2020 | 06/09/2021 |
Preventive Services Policy | Policy Number | Effective Date | End Date |
Preventive Services Policy ![]() |
CPCP006 | 10/01/2021 | 12/31/2021 |
Preventive Services Policy ![]() |
CPCP006 | 07/01/2021 | 09/30/2021 |
Preventive Services Policy ![]() |
CPCP006 | 04/01/2021 | 06/30/2021 |
Preventive Services Policy ![]() |
CPCP006 | 01/15/2021 | 03/31/2021 |
Preventive Services Policy ![]() |
CPCP006 | 01/01/2020 | 01/14/2021 |
Preventive Services Policy ![]() |
CPCP006 | 10/01/2020 | 12/31/2020 |
Preventive Services Policy ![]() |
CPCP006 | 07/01/2020 | 09/30/2020 |
Preventive Services Policy ![]() |
CPCP006 | 04/01/2020 | 06/30/2020 |
Preventive Services Policy ![]() |
CPCP006 | 01/01/2020 | 03/31/2020 |
Preventive Services Policy ![]() |
CPCP006 | 10/15/2019 | 12/31/2019 |
Preventive Services Policy ![]() |
CPCP006 | 10/01/2019 | 10/14/2019 |
Preventive Services Policy ![]() |
CPCP006 | 01/01/2019 | 09/30/2019 |
Preventive Services Policy ![]() |
CPCP006 | 11/01/2018 | 12/31/2018 |
Preventive Services Policy ![]() |
CPCP006 | 06/28/2018 | 10/31/2018 |
Preventive Services Policy ![]() |
CPCP006 | 07/07/2017 | 06/27/2018 |
Psychological and Neuropsychological Testing | Policy Number | Effective Date | End Date |
Psychological and Neuropsychological Testing ![]() |
CPCP008 | 07/10/2020 | 07/11/2021 |
Psychological and Neuropsychological Testing ![]() |
CPCP008 | 02/15/2019 | 07/09/2020 |
Psychological and Neuropsychological Testing ![]() |
CPCP008 | 08/01/2018 | 02/14/2019 |
Psychological and Neuropsychological Testing ![]() |
CPCP008 | 01/01/2018 | 07/31/2018 |
Trauma Activation | Policy Number | Effective Date | End Date |
Trauma Activation ![]() |
CPCP031 | 09/01/2020 | 08/25/2021 |
Trauma Activation ![]() |
TXCPCP02 | 07/01/2019 | 08/31/2020 |
Revenue Codes Requiring CPT, HCPCS and/or NDC Codes | Policy Number | Effective Date | End Date |
Revenue Codes Requiring CPT® or HCPCS Codes ![]() |
CPCP018 | 02/10/2021 | 03/21/2022 |
Revenue Codes Requiring CPT® or HCPCS Codes ![]() |
CPCP018 | 07/01/2020 | 02/09/2021 |
Revenue Codes Requiring CPT or HCPCS Codes ![]() |
CPCP018 | 10/25/2019 | 06/30/2020 |
Revenue Codes Requiring CPT or HCPCS Codes ![]() |
CPCP018 | 11/01/2018 | 10/24/2019 |
Telemedicine and Telehealth Services | Policy Number | Effective Date | End Date |
Telemedicine and Telehealth Services ![]() added coverage for IOP Services |
CPCP033 | 02/12/2021 | 03/24/2021 |
Telemedicine and Telehealth Services ![]() |
CPCP033 | 02/12/2021 | 02/12/2021 |
Telemedicine and Telehealth Services ![]() |
CPCP033 | 02/12/2021 | 02/12/2021 |
Telemedicine and Telehealth Services ![]() |
TXCPCP01 | 01/01/2021 | 02/11/2021 |
Telemedicine and Telehealth Services ![]() |
TXCPCP01 | 05/10/2020 | 12/31/2020 |
Telemedicine and Telehealth Services ![]() |
TXCPCP01 | 07/01/2019 | 05/09/2020 |
Telemedicine and Telehealth Services ![]() |
TXCPCP01 | 11/01/2018 | 06/30/2019 |
Telemedicine and Telehealth Services ![]() |
TXCPCP01 | 04/04/2018 | 10/31/2018 |
Wasted/Discarded Drugs and Biologicals Guideline | Policy Number | Effective Date | End Date |
Wasted/Discarded Drugs and Biologicals Policy ![]() |
CPCP017 | 11/08/2021 | 01/13/2022 |
Wasted/Discarded Drugs and Biologicals Guideline ![]() |
CPCP017 | 01/10/2021 | 11/07/2021 |
Wasted/Discarded Drugs and Biologicals Guideline ![]() |
CPCP017 | 10/25/2019 | 01/09/2021 |
Wasted/Discarded Drugs and Biologicals Guideline ![]() |
CPCP017 | 10/12/2018 | 10/24/2019 |