Payment Policy Updates September 2019

The following Payment Policy has been withdrawn:

Blood Draw/Venipuncture with Office Visit E&M Code
Premera has chosen to not move forward with enforcing the Payment Policy titled “Blood Draw/Venipuncture with Office Visit E&M Code” that was to become effective as of 06/09/2019. The policy has been removed from the external Provider portals and at this time no future editing will be developed for this coding scenario.

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

September 5, 2019

All of the following policies were annually reviewed with no changes:

• Contract Exclusions/Disallowed Charges-Inpatient Facility Services
• Group Psychotherapy Services (90853)
• Modifier 23-Unusual Anesthesia
• Modifier 24-Unrelated E&M service by the Same Physician in the Post-Op period
• Modifier 47-Anesthesia by Surgeon
• Urgent Care Center Services
• NDC Billing Guidelines: Outpatient Facility Claims
• NDC Billing Guidelines-Professional Claims

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