Here are the latest updates to our payment policies. You’ll need to log in to see the policy updates.
July 2021
The following policies had their annual review with no changes to the policy content
The following policies had changes and updates to their policy content
Medicare Indicator “Status B” Services Reimbursement
In the codes/coding guidelines and exceptions sections on the policy, revised and clarified the recent exception being
made for code 99072 concerning personal protective equipment (PPE) submitted by Washington dentists and pharmacists for non-medical services.
Modifier 23 – Unusual Anesthesia
Added the last paragraph in the policy section indicating modifier 23 is not appropriate appended to moderate/conscious sedation codes.
Modifier 24 – Unrelated Evaluation
& Management (E&M) Service by the Same Physician in the Post-Operative Period
Added clarification to second paragraph on how to correctly identify an unrelated E&M visit or eye exam service. Added to the policy section (fourth and fifth paragraphs)
identifying incorrect use of modifier 24 on E&M and eye exam services related to the surgical procedure or when rendered outside of the post-operative period.
Modifier 50 – Bilateral Procedure
Added further clarification to second paragraph on how to bill a procedure code appended with modifier 50.
Personal Protective Equipment (PPE)
In the codes/coding guidelines and exceptions sections on the policy, revised and clarified the recent exception being made for code
99072 concerning PPE submitted by Washington dentists and pharmacists for non-medical services.