Payment Policy Updates November 2018

Here are the latest updates to our payment policies. You’ll need to log in to see the policy updates.

November 15, 2018

1. Group Psychotherapy Services (90853)Annual review; No changes
2. Modifier 23 – Unusual Anesthesia
   Annual review; No changes
3. Modifier 24 – Unrelated E&M by same Physician on the Post-Operative Period
   Annual review; No changes
4. Modifier 47 – Anesthesia by Surgeon
   Reworded the second paragraph with bullets to clearly identify “appropriate” examples of the use of Modifier 47
5. Modifier 57 – Decision for Surgery
   Added the last paragraph in the POLICY section to indicate medical records must document the decision for the surgery
6. Modifier 63 – Procedure Performed on Infants less than 4kg
   Annual review; No changes
7. Modifier TH – Obstetrical Treatment/Services
   Added the new section “CODES/CODING GUIDELINES” listing out the Office Visit and Home Visit codes previously listed in the POLICY section
8. Multiple Deliveries/Births
   Added new section “Codes/Coding Guidelines” and listed all of the codes and descriptions for the types of deliveries referenced in the POLICY section
9. Modifier 66 – Surgical Team
   Annual review; no changes made
10. Modifier 73 – Discontinued ASC Procedure prior to Administration of Anesthesia
    Annual review; no changes made
11. Modifier 74 – Discontinued ASC Procedure after Administration of Anesthesia
    Annual review; no changes made
12. Modifier 76 – Repeat Procedure by the same Provider
    Annual review; no changes made
13. Modifier 77 – Repeat Procedure by another Provider
    Annual review; no changes made

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