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Updated: 00.01.25f PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Posted: 10/30/2009


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Effective November 1, 2009, claim payment policy 00.01.25f PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services has been updated. To keep you best informed about any additional updates made to the policy, they will be featured in our News and Announcements section.

The following ADDITIONS have been made to the policy:
  • Pathologist are now eligible for reimbursement when billing the following CPT codes in the outpatient hospital setting (Information listed on policy Attachment B3):
    o 88104-26
    o 88106-26
    o 88107-26
    o 88108-26
    o 88112-26
    o 88125-26
    o 88130
    o 88140
    o 88155
    o 88160-26
    o 88161-26
    o 88162-26
    o 88172-26
    o 88173-26
    o 88182-26
    o 88230
    o 88233
    o 88235
    o 88237
    o 88239
    o 88240
    o 88241
    o 88245
    o 88248
    o 88249
    o 88261
    o 88262
    o 88263
    o 88264
    o 88267
    o 88269
    o 88271
    o 88272
    o 88273
    o 88274
    o 88275
    o 88280
    o 88283
    o 88285
    o 88289
    o 88300-26
    o 88307-26
    o 88309-26
    o 88311-26
    o 88314-26
    o 88318-26
    o 88319-26
    o 88323-26
    o 88331-26
    o 88332-26
    o 88333-26
    o 88334-26
    o 88346-26
    o 88347-26
    o 88348-26
    o 88349-26
    o 88356-26
    o 88358-26
    o 88360-26
    o 88361-26
    o 88362-26
    o 88365-26
    o 88367-26
    o 88368-26
If you have any questions, contact your Network Coordinator.
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