Commercial Reimbursement Policy Updates for September 18, 2023
Reimbursement Policy | Revision |
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Diagnosis Validity (PDF) | Added “CMS instruction” to correct diagnostic coding in Reimbursement Guidelines.
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| Modifier JZ added to Billing and Coding. Instruction for drugs with multiple administration routes added to Reimbursement Guidelines.
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Global Surgery (PDF) | Non-physician practitioners reimbursement of a Major Procedure (90 day) language added to Reimbursement Guidelines. Medical Director approved.
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Modifier Guidelines (PDF) | Added Erythropoiesis stimulating agent (ESA) modifiers, deceased modifiers, Modifier PI, and X-Ray Transportation.
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