AmeriHealth Providers' Page
medPolicy_AHnav
Med Pol Banner
Medical Policy
> User Information

__		 Policy Bulletin User Information
About Policy Numbers

All of our medical and claim payment policies are assigned a unique policy number. This number, found at the top of the policy with the title, classifies the policy according to its appropriate general policy category, sub-category, and specific policy topic. Below is a table that explains the numeric system that we use to determine each policy’s number.

The policies in the Medical Policy (Family of Companies) Database use the following numeric classification system:

The first two digits (00.00.00) of the policy number denote a general category.

The second two digits (00.00.00) of the policy number reference sub-categories under each general category.

The last two digits (00.00.00) of the policy number denote a specific policy within a category and a sub-category.

Please note: our policies also use a letter after the policy number to denote the policy version. A policy number with the letter “d” as a suffix supersedes the policy version with the letter “c.” A policy with no lettered suffix is the original version of the policy.
Numeric System
Category
Sub-Category
Sub-Category Number
00 Administrative
00.00.00
Administrative Policies
00.01.00
Perinatal Case Management
00.02.00
Capitated Services
00.03.00
Connections
00.04.00
Mother's Option
00.05.00
Preventive Services (PPIP, Wellness)
00.06.00
Quality Focus
Note: Effective 01/01/2002, the Cardiology Quality-Focused Specialty Care Program and the Gastroenterology Quality-Focused Specialty Care Program have been deleted.
00.07.00
QIPS
00.08.00
Specialty Programs
00.09.00
Physician Services
00.10.00
PCM Review
00.11.00
01 Anesthesia
01.00.00
02 Case Management
02.00.00
Home Health Care
02.01.00
Hospice Care
02.02.00
03 Clinical Logic
03.00.00
Auditory System
03.01.00
Cardiovascular System
03.02.00
Central Nervous System
03.03.00
Endocrine System
03.04.00
Gastrointestinal System
03.05.00
Hemic and Lymphatic Systems
03.06.00
Integumentary System
03.07.00
Musculoskeletal System
03.08.00
Obstetrics
03.09.00
Reproductive Systems
03.10.00
Respiratory System
03.11.00
Urinary System
03.12.00
Visual System
03.13.00
Radiology
03.14.00
Pathology & Laboratory (Clinical and Anatomical)
03.15.00
04 Dental
04.00.00
05 Durable Medical Equipment (DME)
05.00.00
06 Pathology and Laboratory
06.00.00
Anatomical Pathology
06.01.00
Clinical Pathology
06.02.00
Transfusion Medicine
06.03.00
07 Medicine
07.00.00
Auditory System
07.01.00
Cardiovascular System
07.02.00
Central Nervous System
07.03.00
Endocrine System
07.04.00
Gastrointestinal System
07.05.00
Hemic and Lymphatic Systems
07.06.00
Integumentary System
07.07.00
Musculoskeletal System
07.08.00
Obstetrics
07.09.00
Reproductive Systems
07.10.00
Respiratory System
07.11.00
Urinary System
07.12.00
Visual System
07.13.00
08 Drugs and Biologics
08.00.00
09 Radiology
09.00.00
10 Rehabilitation Services
10.00.00
Cardiac Rehab
10.01.00
Chiropractic
10.02.00
Physical Therapy
10.03.00
Pulmonary Therapy
10.04.00
Occupational Therapy
10.05.00
Speech Therapy
10.06.00
11 Surgery
11.00.00
Auditory System
11.01.00
Cardiovascular System
11.02.00
Digestive System
11.03.00
Endocrine System
11.04.00
Eye and Ocular Adnexa
11.05.00
Female Genital System
11.06.00
Hemic and Lymphatic Systems
11.07.00
Integumentary System
11.08.00
Intersex Surgery
11.09.00
Laparoscopy/Peritoneoscopy/ Hysteroscopy
11.10.00
Male Genital System
11.11.00
Maternity Care and Delivery
11.12.00
Mediastinum and Diaphragm
11.13.00
Musculoskeletal System
11.14.00
Nervous System
11.15.00
Respiratory System
11.16.00
Urinary System
11.17.00
12 Miscellaneous
12.00.00
Investigational
12.01.00
Routine Eye Exam
12.02.00
Specific Specialty
12.03.00
Transportation
12.04.00
Education
12.05.00
Copyright © 2012 AmeriHealth - All Rights Reserved.