October Payment Policy Updates
The
following payment policies received annual review with no changes to policy
content:
Consultation Code Services
Contract Exclusions/Disallowed Charges –Inpatient and Outpatient Facility Services
Modifier 26 – Professional Component
Modifier SU – Procedure Performed in Physician's Office
Modifier TC – Technical Component
Multiple Endoscopy Procedure Reductions
Multiple Modifiers
The following payment policies
received their annual review with the changes noted below:
Acupuncture
In the policy section, clarified the guidelines for billing an evaluation and management (E&M) service on the same date as an acupuncture service. Also added the last paragraph clarifying coding guidelines for coding acupuncture codes along with needle
insertion codes. In the codes/coding guidelines, added codes and code descriptions for 20560 and 20561.
Manipulation Services
In the policy section, clarified the guidelines for billing an evaluation and management (E&M) service on the same date as a chiropractic or osteopathic manipulation.
Telehealth/Telemedicine
Services
In the telephone/audio only section, added a paragraph indicating
that member consent for an audio-only encounter needs to be obtained prior the
encounter. Clarified the definitions of the originating and distant site
providers. Removed codes from the codes/coding guidelines section that are no
longer active codes. Added a new definition for "audio-only telemedicine" in
the definitions section.
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