Clinical Payment and Coding Policy - Archived Documents

 

Observation Services Policy Policy Number Effective Date End Date
Observation Services Policy CPCP001 06/22/2023 07/12/2023
Inpatient/Outpatient Unbundling Policy Policy Number Effective Date End Date
Inpatient/Outpatient Unbundling Policy CPCP002 04/01/2019 09/29/2019
Inpatient/Outpatient Unbundling Policy V6 CPCP002 09/30/2019 12/04/2020
Home Health Care/Private Duty Nursing Policy Policy Number Effective Date End Date
Coordinated Home Care/Private Duty Nursing Policy CPCP005 08/08/2021 11/12/2023
Preventive Services Policy Policy Number Effective Date End Date
Preventive Services Policy CPCP006 10/01/2023 10/31/2023
Preventive Services Policy CPCP006 07/01/2023 09/30/2023
Preventive Services Policy CPCP006 04/01/2023 06/30/2023
Preventive Services Policy CPCP006 03/01/2023 03/30/2023
Preventive Services Policy V1 CPCP006 01/01/2023 02/28/2023
Preventive Services Policy V1 CPCP006 10/01/2022 12/31/2022
Preventive Services Policy V1 CPCP006 09/01/2022 09/30/2022
Preventive Services Policy V1 CPCP006 07/01/2022 08/31/2022
Preventive Services Policy V1 CPCP006 03/01/2022 06/30/2022
Preventive Services Policy V1 CPCP006 01/01/2022 03/31/2022
Preventive Services Policy V2 CPCP006 07/01/2021 09/30/2021
Preventive Services Policy V2 CPCP006 04/01/2021 07/01/2021
Preventive Services Policy V2 CPCP006 01/15/2021 04/01/2021
Preventive Services Policy V2 CPCP006 01/01/2021 01/15/2021
Preventive Services Policy V2 CPCP006 07/01/2020 09/30/2020
Preventive Services Policy V 2.0 CPCP006 10/15/2019 01/01/2020
Preventive Services Policy V 1.0 CPCP006 04/01/2020  
Preventive Services Policy V 6.0 CPCP006 01/01/2020 N/A
Preventive Services Policy V1 CPCP006 10/01/2020 01/01/20
Psychological and Neuropsychological Testing Policy Number Effective Date End Date
Psychological and Neuropsychological Testing V1 CPCP008 12/16/2022 12/04/2023
Psychological and Neuropsychological Testing V1 CPCP008 03/31/2021 12/16/2022
Psychological and Neuropsychological Testing V2 CPCP008 03/04/2020 03/31/2021
Psychological and Neuropsychological Testing V5 ECPCP008 3/01/2018 3/4/2020
Co-Surgeon/Team Surgeon Modifiers Policy Number Effective Date End Date
Co-Surgeon/Team Surgeon Modifiers V1  CPCP009  09/16/2020  09/25/2023
Co-Surgeon/Team Surgeon Modifiers V1  CPCP009  09/16/2020  10/04/2021
Co-Surgeon/Team Surgeon Modifiers V4 CPCP009 01/01/2019 09/16/2020
Anesthesia Policy Number Effective Date End Date
Anesthesia CPCP010 10/01/2022 03/30/2023
Anesthesia CPCP010 10/13/2021 9/30/2020
Applied Behavior Analysis Policy Number Effective Date End Date
Applied Behavior Analysis V9 CPCP011 02/22/2019 3/6/2020
Applied Behavior Analysis V1 CPCP011 03/28/2020 11/25/2020
Applied Behavior Analysis V2 CPCP011 11/25/2020 12/18/2020
Applied Behavior Analysis V1 CPCP011 11/09/2021 06/12/2023
Hernia Repair Policy Number Effective Date End Date
Hernia Repair CPCP012 06/18/2021 04/22/2022
Hernia Repair CPCP012 04/28/2022 05/17/2023
Increased Procedural Services (Modifier 22) Policy Number Effective Date End Date
Increased Procedural Services (Modifier 22) CPCP013 02/24/2022 05/17/2023
Global Surgical Package Policy Number Effective Date End Date
Global Surgical Package CPCP014 01/25/2019 04/30/2020
Global Surgical Package CPCP014 04/30/2020 05/11/2021
Global Surgical Package CPCP014 05/11/2021 08/02/2022
Global Surgical Package CPCP014 08/02/2022 06/26/2023
Multiple Surgical Procedures Policy Number Effective Date End Date
Multiple Surgical Procedures v1 CPCP015 06/24/2022 09/26/2023
Multiple Surgical Procedures v1 CPCP015 08/24/2021 06/24/2022
Multiple Surgical Procedures V1 CPCP015 07/07/2020 08/24/2021
Multiple Surgical Procedures V6 CPCP015 02/22/2019 07/07/2020
Chiropractic Services Policy Number Effective Date End Date
Chiropractic Services CPCP016 08/15/2019 09/25/2020
Chiropractic Services CPCP016 12/16/2021 03/28/2023
Wasted/Discarded Drugs and Biologicals Guideline Policy Number Effective Date End Date
Wasted/Discarded Drugs and Biologicals Guideline V4  CPCP017  10/26/2021  02/13/2023
Wasted/Discarded Drugs and Biologicals Guideline V3  CPCP017  09/11/2020  10/26/2021
Wasted/Discarded Drugs and Biologicals Guideline V5 CPCP017 06/26/2019 09/11/2020
Home Infusion Policy Number Effective Date End Date
Home Infusion CPCP019 01/03/2023 11/12/2023
Home Infusion V 3.0 CPCP019 09/07/2021 01/03/2023
Home Infusion V 2.0 CPCP019 6/17/2020 09/07/2021
Home Infusion V 2.0 CPCP019 06/30/2020 04/30/2020
Drug Testing Policy Number Effective Date End Date
Drug Testing Clinical Payment and Coding Policy CPCP020 03/30/2023 12/04/2023
Drug Testing Clinical Payment and Coding Policy CPCP020 01/14/2022 03/30/2023
Drug Testing Clinical Payment and Coding Policy (Retired 12/31/2021) CPCP020 10/22/2021 12/31/2021
Drug Testing Policy CPCP020 09/04/2020 10/21/2021
Drug Testing Policy CPCP020 12/20/2020 09/04/2020
Laboratory Panel Billing Policy Number Effective Date End Date
Laboratory Panel Billing CPCP021 06/04/2021 07/30/2021
Laboratory Panel Billing CPCP021 07/30/21 04/06/22
Laboratory Panel Billing CPCP021 04/06/22 06/26/23
Pneumatic Compression Devices – Outpatient Use Policy Number Effective Date End Date
Pneumatic Compression Devices – Outpatient Use CPCP022 01/14/2022 02/13/2023
Pneumatic Compression Devices – Outpatient Use CPCP022 07/01/2019 08/31/2020
Modifier Reference Policy  Policy Number Effective Date End Date
Modifier Reference Policy CPCP023 03/30/23 11/12/23
Modifier Reference Guideline V1 CPCP023 05/13/22 03/30/23
Modifier Reference Guideline V1 CPCP023 04/08/22 05/13/22
Modifier Reference Guideline V2 CPCP023 03/31/21 04/08/22
Evaluation and Management (E/M) Coding – Professional Provider Services Policy Number Effective Date End Date
Evaluation and Management (E/M) Coding – Professional Provider Services CPCP024 06/22/23 12/04/23
Evaluation and Management (E/M) Coding – Professional Provider Services V3 CPCP024 12/07/20 06/22/23
Therapeutic, Prophylactic and Diagnostic Injection and Infusion Coding Policy Number Effective Date End Date
Therapeutic, Prophylactic and Diagnostic Injection and Infusion Coding V3 CPCP026 10/05/21 01/03/23
Therapeutic, Prophylactic and Diagnostic Injection and Infusion Coding V3 CPCP026 01/03/23 05/17/23
Inpatient Readmissions Policy Number Effective Date End Date
Inpatient Readmissions CPCP027 03/01/23 06/30/23
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) Policy Number Effective Date End Date
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) CPCP028 09/01/23 09/30/23
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) CPCP028 06/01/23 08/31/23
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) V3 CPCP028 03/27/23 05/31/23
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) V3 CPCP028 12/07/22 06/31/23
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) V3 CPCP028 10/07/22 03/31/23
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) V3 CPCP028 08/01/22 12/31/22
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) V3 Effective Date 4/22/22 CPCP028 08/01/22 12/31/22
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) V2 Effective Date 4/15/22 CPCP028 04/15/22 04/15/2022
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) V2 CPCP028 07/01/2021 04/01/2022
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) CPCP028 11/20/2020  
Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) CPCP028 09/01/2020 12/01/2020
Medical Record Documentation Policy Number Effective Date End Date
Medical Record Documentation CPCP029 09/16/2022 11/12/2023
Medical Record Documentation Guidelines V5 CPCP029 09/22/2021 09/15/2022
Medical Record Documentation Guidelines V1 CPCP029 03/31/2021 09/21/2021
Medical Record Documentation Guidelines V1 CPCP029 02/06/2020 03/31/2021
Medical Record Documentation OKCPCP01 09/01/2018 02/05/2020
Trauma Activation- Facility Services Policy Number Effective Date End Date
Trauma Activation- Facility Services V1 CPCP031 02/24/2022 07/12/2023
Trauma Activation- Facility Services V1 CPCP031 05/22/2021 02/24/2022
Intraoperative Neurophysiology Monitoring (IONM) Coding and Reimbursement Guideline Policy Number Effective Date End Date
Intraoperative Neurophysiology Monitoring (IONM) Coding and Reimbursement Guideline CPCP032 04/22/2022 09/26/2023
Intraoperative Neurophysiology Monitoring (IONM) Coding and Reimbursement Guideline V3 CPCP032 07/30/2021 04/22/2022
 
Telemedicine and Telehealth Services Policy Number Effective Date End Date
Telemedicine and Telehealth Services V5 CPCP033 02/08/2020 03/18/2021
Telemedicine and Telehealth Services V10 CPCP033 01/01/2021 02/08/2021
Telemedicine and Telehealth Services V9 CPCP033 01/01/2021 01/01/2021
Telemedicine and Telehealth Services V10 CPCP033 03/18/2022 03/28/2022
Telemedicine and Telehealth Services V10 CPCP033 03/18/2021 03/28/2022
Telemedicine and Telehealth Services CPCP033 03/28/2022 12/05/2023
Unbundling Policy-Professional Providers Policy Number Effective Date End Date
Unbundling Policy-Professional Providers V2 CPCP034 08/04/2021 04/05/2022
Unbundling Policy-Professional Providers V1 CPCP034 04/05/2022 05/17/2023
Unlisted/Not Otherwise Classified (NOC) Coding Policy Policy Number Effective Date End Date
Unlisted/Not Otherwise Classified (NOC) Coding Policy v3 CPCP035 05/31/2022 09/02/2022
Paravertebral Facet Injection Procedure Coding & Billing Policy Policy Number Effective Date End Date
Paravertebral Facet Injection Procedure Coding & Billing Policy CPCP036 01/03/2023 11/12/2023
Paravertebral Facet Injection Procedure V1 CPCP036 01/14/2022 01/03/2023
Lab Management Program Policy Number Effective Date End Date
Lab Management Program V1 CPCP037 12/01/2021 08/24/2021