Jan. 7, 2024
Clinical Payment and Coding Policies describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10 coding for claims submitted as covered services. This information is a resource for our payment policies. It’s not intended to address all reimbursement-related issues. We regularly add and modify clinical payment and coding policy positions as part of our ongoing policy review process.
The following policies were updated:
- CPCP006: Preventive Services Policy – Effective 1/1/25
- CPCP018: Outpatient Facility and Hospital Claims: Revenue Codes Requiring Supporting CPT, HCPCS and/or NDC Codes – Effective 4/14/25
- CPCP027: Inpatient Readmission – Effective 12/18/24
- CPCP030: Point-of-Care Ultrasound (POCUS) Examination Policy – Effective 1/7/25
- CPCP041: Sepsis Policy – Effective 1/7/25