Payment Policy Updates January 2022

January 2022 Payment Policy Updates

The following policies received their annual review with no changes:

• After hours services
• Blood draw/venipuncture – 36415
• Facility fees: clinic services, professional fees and specialty services/treatment room
• Home birth kit- S8415
• Modifier 79: unrelated procedure/service by same provider during postoperative period
• Modifier SL: state supplied vaccine
• New and established patient guidelines

The following policies received their annual review with the changes/edits noted:

• Claims Editing System (CES)-Exceptions - Revised the policy to make it applicable to all the claims editors currently in place. Split the original second paragraph into two paragraphs. Deleted claim examples which are no longer valid.
• Modifier 80/81/82 – Assistant Surgeon-Physician - Removed reference to the What If tool at the end of the policy.
• Modifier AS-physician assistant, nurse practitioner or clinical nurse specialist services for assistant at surgery-non-physician - Removed reference to the What If  tool at the end of the policy.

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