January 2012 (Page2)





This page gives you a listing of everything that has happened on the site this month. There are no active links.


    00.10.01p, Services Paid Above Capitation for Health Maintenance Organization (HMO) Primary Care Physicians
    Policy Update
    Posted: 1/27/2012


    09.00.46e, High-Technology Diagnostic Radiology Services
    Policy Update
    Posted: 1/27/2012


    11.08.15n, Reconstructive Breast Surgery
    Policy Update
    Posted: 1/25/2012


    11.08.15m, Reconstructive Breast Surgery
    Policy Update
    Posted: 1/24/2012


    08.00.62d, Abatacept (Orencia®) for injection for intravenous use
    Policy Update
    Posted: 1/24/2012


    08.00.94c, Denosumab (Prolia™, Xgeva™)
    Policy Update
    Posted: 1/23/2012


    00.01.18b, Reimbursement for Associated Services Performed in Conjunction with Dental Services
    Policy UpdatePosted: 1/20/2012
    12.00.03a, Alternative Therapies and Complementary Medicine
    Policy UpdatePosted: 1/20/2012
    08.01.02, Pegloticase (Krystexxa®)
    New PolicyPosted: 1/20/2012
    08.00.75d, Erythropoiesis-Stimulating Agents (ESAs)
    Policy UpdatePosted: 1/20/2012
    00.10.21b, Collection and Interpretation of Physiologic Data
    Policy ArchivedPosted: 01/20/2012
    10.01.01i,Cardiac Rehabilitation and Intensive Cardiac Rehabilitation Programs
    NotificationPosted: 1/18/2012
    11.14.02i, Trigger Point Injections
    Policy UpdatePosted: 1/18/2012
    08.00.84a, Eculizumab (Soliris®)
    Policy UpdatePosted: 1/18/2012
    11.08.19j, Prophylactic Mastectomy
    NotificationPosted: 1/18/2012
    05.00.30f, Noninvasive Respiratory Assist Devices (RADs): Continuous Positive Airway Pressure (CPAP) Devices and Bi-Level Devices
    NotificationPosted: 1/17/2012
    06.02.09e, Human Immunodeficiency Virus (HIV) Genotyping and Phenotyping
    NotificationPosted: 1/17/2012
    00.03.02k, Diagnostic Radiology Services Included in Capitation
    Coding UpdatePosted: 1/17/2012
    00.03.01j, Podiatry Services Included in Capitation for Pennsylvania Based Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
    Coding UpdatePosted: 1/13/2012
    00.01.52a, Always Bundled Procedure Codes
    Coding UpdatePosted: 1/13/2012
    07.00.15j, Reimbursement for the Administration of Immunizations
    Policy UpdatePosted: 1/12/2012
    11.05.11a, Implantation of Intrastromal Corneal Ring Segments (INTACS)
    ReissuePosted: 1/11/2012
    08.01.04, Preventive Immunization
    New PolicyPosted: 1/11/2012
    05.00.59e, Lower Limb Prostheses
    Coding UpdatePosted: 1/10/2012
    05.00.56e, Hospital Beds and Accessories
    Policy UpdatePosted: 1/10/2012
    08.01.02, Pegloticase (Krystexxa®)
    NotificationPosted: 1/10/2012
    03.00.12d, Modifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician Following the Initial Procedure for a Related Procedure During the Postoperative Period
    Coding UpdatePosted: 1/10/2012
    03.00.07k, Modifier 51: Multiple Procedures
    Coding UpdatePosted: 1/10/2012
    03.00.31d, Modifiers for Split or Shared Surgical Services (Modifiers 54, 55, and 56)
    Coding UpdatePosted: 1/10/2012
    03.00.10g, Modifiers LT/RT: Left Side/Right Side Procedures
    Coding UpdatePosted: 1/10/2012
    00.01.25n, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
    Coding UpdatePosted: 1/9/2012
    05.00.72a, Upper-Limb Prostheses
    Coding UpdatePosted: 1/9/2012
    00.10.39b, Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
    Coding UpdatePosted: 1/9/2012
    05.00.32d, Speech- and Non-Speech-Generating Devices
    Coding UpdatePosted: 1/9/2012
    11.08.20i, Wound Care: Bioengineered Skin Substitutes
    Coding UpdatePosted: 1/9/2012
    11.08.25f, Scar Revision
    Coding UpdatePosted: 1/9/2012


    Issued on - 1/23/2012