Clinical Payment and Coding Policy - Archived Documents

Inpatient/Outpatient Unbundling PolicyPolicy NumberEffective DateEnd Date
Inpatient/Outpatient Unbundling Policy PDF Document CPCP002 04/01/2019 09/29/2019
Inpatient/Outpatient Unbundling Policy V6 PDF Document CPCP002 09/30/2019 12/04/2020
Preventive Services PolicyPolicy NumberEffective DateEnd Date
Preventive Services Policy V2 PDF Document CPCP006 04/01/2021 07/01/2021
Preventive Services Policy V2 PDF Document CPCP006 01/15/2021 04/01/2021
Preventive Services Policy V2 PDF Document CPCP006 01/01/2021 01/15/2021
Preventive Services Policy V2 PDF Document CPCP006 07/01/2020 09/30/2020
Preventive Services Policy V 2.0 PDF Document CPCP006 10/15/2019 01/01/2020
Preventive Services Policy V 1.0 PDF Document CPCP006 04/01/2020  
Preventive Services Policy V 6.0 PDF Document CPCP006 01/01/2020 N/A
Preventive Services Policy V1 PDF Document CPCP006 10/01/2020 01/01/20
Psychological and Neuropsychological TestingPolicy NumberEffective DateEnd Date
Psychological and Neuropsychological Testing V2 PDF Document CPCP008 03/04/2020 03/31/2021
Co-Surgeon/Team Surgeon ModifiersPolicy NumberEffective DateEnd Date
Co-Surgeon/Team Surgeon Modifiers V4 PDF Document CPCP009 01/01/2019 09/16/2020
Applied Behavior AnalysisPolicy NumberEffective DateEnd Date
Applied Behavior Analysis V9 PDF Document CPCP011 02/22/2019 3/6/2020
Applied Behavior Analysis V1 PDF Document CPCP011 03/28/2020 11/25/2020
Applied Behavior Analysis V2 PDF Document CPCP011 11/25/2020 12/18/2020
Global Surgical PackagePolicy NumberEffective DateEnd Date
Global Surgical Package PDF Document CPCP014 01/25/2019 04/30/2020
Global Surgical Package PDF Document CPCP014 04/30/2020 05/11/2021
Multiple Surgical ProceduresPolicy NumberEffective DateEnd Date
Multiple Surgical Procedures v1 PDF Document CPCP015 07/07/2020 08/24/2021
Multiple Surgical Procedures V6 PDF Document CPCP015 02/22/2019 07/07/2020
Chiropractic ServicesPolicy NumberEffective DateEnd Date
Chiropractic Services PDF Document CPCP016 08/15/2019 09/25/2020
Wasted/Discarded Drugs and Biologicals GuidelinePolicy NumberEffective DateEnd Date
Wasted/Discarded Drugs and Biologicals Guideline V5 PDF Document CPCP017 06/26/2019 09/11/2020
Home InfusionPolicy NumberEffective DateEnd Date
Home Infusion V 2.0 PDF Document CPCP019 06/30/2020 04/30/2020
Drug TestingPolicy NumberEffective DateEnd Date
Drug Testing Policy PDF Document CPCP020 12/20/2020 09/04/2020
Laboratory Panel BillingPolicy NumberEffective DateEnd Date
Laboratory Panel Billing  CPCP021 06/04/2021 07/30/2021
Pneumatic Compression Devices – Outpatient UsePolicy NumberEffective DateEnd Date
Pneumatic Compression Devices – Outpatient Use PDF Document CPCP022 07/01/2019 08/31/2020
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU)Policy NumberEffective DateEnd Date
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) V10  Effective Date 1/1/21 CPCP028 01/01/2021 03/01/2021
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) V10  Effective Date 3/1/21 CPCP028 03/01/2021 04/01/2021
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) V10  Effective Date 4/1/21 CPCP028 04/01/2021 05/15/2021
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) V1  Effective Date 5/15/21 CPCP028 05/15/2021 07/01/2021
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) PDF Document CPCP028 11/20/2020  
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) PDF Document CPCP028 09/01/2020 12/01/2020
Telemedicine and Telehealth ServicesPolicy NumberEffective DateEnd Date
Telemedicine and Telehealth Services V5 PDF Document CPCP033 02/08/2020 03/18/2021
Telemedicine and Telehealth Services V10 PDF Document CPCP033 01/01/2021 02/08/2021
Telemedicine and Telehealth Services V9 PDF Document CPCP033 01/01/2021 01/01/2021
Medical Record DocumentationPolicy NumberEffective DateEnd Date
Medical Record Documentation Guidelines V1 PDF Document CPCP029 02/06/2020 03/31/2021
Medical Record Documentation PDF Document OKCPCP01 09/01/2018 02/05/2020
Psychological and Neuropsychological TestingPolicy NumberEffective DateEnd Date
Psychological and Neuropsychological Testing V5 PDF Document ECPCP008 3/01/2018 3/4/2020