Policy Updates October 2014

The information outlines updates to policies that are effective this month. To view the updated policy in its entirety, select the policy name

Policy Name Affected Physicians Updates Effective Date
Facility Routine Services and Supplies*
  • Anesthesiologists
  • Cardiologists
  • Facilities
  • Family practice physicians
  • Gastroenterologists
  • Hematologists
  • Internal medicine physicians
  • OB/GYNs
  • Oncologists
  • Orthopedists
  • Pain management physicians
  • Radiologists

Duplicative claims for the following CPT® codes associated with routine services and injections will be denied: 92586 and 92558.

10/20/2014

Healthcare Common Procedure Coding System (HCPCS) National Level II Modifier Policy (Modifier SU)*
  • Physicians who do surgery in the office setting

We will no longer provide reimbursement for submitted claims that have codes appended with an SU Modifier.

10/20/2014

* Please log in to view these policies.

The appearance of an item or procedure in this update indicates only that we have recently adopted or revised a policy. It does not imply that we provide coverage for the items or procedures listed. In the event of an inconsistency or conflict between the information provided below and the posted policy, the provisions of the posted policy will prevail.