| A |
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| Advanced Notification - DRG Readmissions - (R35) |
PDF |
159kB |
07/01/2025 |
| Advanced Notification - Evaluation and Management Services - (R30) |
PDF |
284kB |
06/01/2025 |
| Advanced Notification - Modifier - Bilateral Procedures - (M50) |
PDF |
190kB |
03/15/2025 |
| Advanced Notification - Retail Pharmacy Reimbursement Policy - (R48) |
PDF |
187kB |
09/01/2024 |
| Advanced Practice Health Care Providers - (R37) |
PDF |
155kB |
01/10/2025 |
| Ambulance Services - (R18) |
PDF |
307kB |
01/01/2025 |
| Anesthesia Services - (R39) |
PDF |
322kB |
01/10/2025 |
| C |
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| Care Integration Services - (R32) |
PDF |
293kB |
03/16/2025 |
| Coding and Billing Accuracy - (R46) |
PDF |
178kB |
01/13/2025 |
| COVID-19 Interim Billing Guidelines - (R33) |
PDF |
368kB |
01/10/2025 |
| D |
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| Diagnosis Coding Guidelines - (R47) |
PDF |
175kB |
01/10/2025 |
| Dialysis Services and Supplies - (R16) |
PDF |
190kB |
01/10/2025 |
| DRG Clinical Review Program - (R20) |
PDF |
172kB |
01/01/2025 |
| DRG Readmissions - (R35) |
PDF |
155kB |
01/01/2025 |
| Drug Testing Billing Requirements - (R25) |
PDF |
246kB |
01/10/2025 |
| E |
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|
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| Emergency Room Services - (R36) |
PDF |
303kB |
01/10/2025 |
| Evaluation and Management Services - (R30) |
PDF |
284kB |
02/28/2025 |
| F |
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| Facility Services, Supplies and Equipment - (R12) |
PDF |
610kB |
01/01/2025 |
| Frequency Editing - (R34) |
PDF |
143kB |
01/10/2025 |
| G |
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| Genetic Testing Panels - (R28) |
PDF |
189kB |
01/15/2025 |
| Global Maternity Obstetric Package - (R11) |
PDF |
201kB |
01/10/2025 |
| Global Surgical Package and Related Modifiers (24, 54, 55, 56, 57, 58, 76, 77, 78 and 79) - (R23) |
PDF |
235kB |
01/10/2025 |
| H |
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| Hospital Acquired Conditions - (R19) |
PDF |
190kB |
01/10/2025 |
| Hospital in the Home - (R42) |
PDF |
142kB |
01/01/2025 |
| I |
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| Implant Billing Requirements - (R13) |
PDF |
174kB |
01/01/2025 |
| L |
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| Laboratory Services - (R17) |
PDF |
244kB |
01/10/2025 |
| M |
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| Modifier - Assistant Surgeon, Co-Surgeon (Two-Surgeons), and Surgical Team Code List - (MAS) |
XLSX |
261kB |
07/08/2021 |
| Modifier - Assistant Surgeon – Modifiers 80, 81, 82 Assistant-At-Surgery – Modifier AS Co-Surgeon (Two Surgeons) – Modifier 62 Surgical Team – Modifier 66 - (MAS) |
PDF |
200kB |
01/10/2025 |
| Modifier - Bilateral Procedures - (M50) |
PDF |
204kB |
01/10/2025 |
| Modifier - Distinct Procedural Service - (M59) |
PDF |
200kB |
01/10/2025 |
| Modifier - Distinct Procedural Service Code List - CMS/NCCI Documentation Requirement List - (M59) |
XLSX |
56kB |
08/19/2013 |
| Modifier - Healthcare Common Procedure Coding System (HCPCS) National Level II Modifiers (MHCPCS) |
PDF |
322kB |
01/10/2025 |
| Modifier - Increased Procedural Services - (M22) |
PDF |
179kB |
01/10/2025 |
| Modifier - Modifier 25 - Code List |
XLS |
42kB |
01/10/2024 |
| Modifier - Multiple Procedures - (M51) |
PDF |
184kB |
01/10/2025 |
| Modifier - Professional Component - (M26) |
PDF |
165kB |
01/10/2025 |
| Modifier Reference Guide - (MRG) |
PDF |
256kB |
01/10/2025 |
| Modifier - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service - (M25) |
PDF |
188kB |
01/10/2025 |
| Modifier - Technical Component (MTC) |
PDF |
157kB |
01/10/2025 |
| Multiple Births - (R03) |
PDF |
202kB |
01/10/2025 |
| Multiple Procedure Reduction - Radiology - (R01) |
PDF |
169kB |
01/10/2025 |
| N |
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| Never Events - (R05) |
PDF |
212kB |
01/10/2025 |
| Newborn Inpatient Level of Care Billing Guidelines - (R29) |
PDF |
80kB |
01/01/2025 |
| O |
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| Omnibus Reimbursement Policy - (R24) |
PDF |
247kB |
01/10/2025 |
| P |
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| Pharmacy and Infusion Services - (R14) |
PDF |
267kB |
01/01/2025 |
| Physician Interpretation and Report (I&R) Services - (R26) |
PDF |
167kB |
01/10/2025 |
| Postoperative Continuous Local Delivery of Analgesia - (R06) |
PDF |
136kB |
01/10/2025 |
| Precertification - (R21) |
PDF |
102kB |
01/02/2019 |
| Preventive Medicine Evaluation and Management Service and Problem Based Evaluation and Management Service on the Same Day - (R02) |
PDF |
230kB |
01/10/2025 |
| Procedure and Place of Service - (R43) |
PDF |
386kB |
02/14/2025 |
| Professional Bundled Services - (R44) |
PDF |
162kB |
01/10/2025 |
| Professional Services Performed by Facility Owned Practices - (R40) |
PDF |
322kB |
01/01/2025 |
| R |
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| Refractive Vision Services - (R10) |
PDF |
166kB |
01/10/2025 |
| Related Services, Supplies, Drugs, and Equipment - (R27) |
PDF |
170kB |
01/10/2025 |
| Respiratory Services and Supplies - (R15) |
PDF |
219kB |
01/01/2025 |
| Retail Pharmacy Reimbursement Policy - (R48) |
PDF |
200kB |
01/10/2025 |
| Revenue Code Billing Requirements - (R41) |
PDF |
254kB |
01/01/2025 |
| Robotic Assisted Surgery - (R04) |
PDF |
121kB |
07/18/2023 |
| U |
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| Unacceptable Primary/Principal Diagnosis Policy - (R38) |
PDF |
161kB |
01/10/2025 |
| Unlisted Codes - (R08) |
PDF |
173kB |
01/10/2025 |
| V |
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| Virtual Care - (R31) |
PDF |
444kB |
01/22/2025 |