10/1/2019 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products



    Purpose

    The intent of this article is to communicate Medicare Advantage Product coverage positions for services identified through the Quarterly Code Update process. The procedure codes that represent these services will become effective on 10/1/2019.

    For more information related to these services, refer to specific policies when applicable.

    Coverage Statement

    As a result of the Quarterly Code Update process, the following services have been reviewed, and coverage determinations made by the Company are identified below. The procedure codes that represent these services will be effective on 10/1/2019.

    Coding

    Inclusion of a code in this article does not imply reimbursement. Medical Necessity, eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.


    ELIGIBLE SERVICES

    J0121

    J0122

    J0222

    J0291

    J0593

    J1096

    J1097

    J1303

    J1943

    J1944

    J2798

    J3031

    J3111

    J7314

    J7331

    J7332

    J9118

    J9119

    J9204

    J9210

    J9269

    J9313

    Q4205

    Q4206

    Q4208

    Q4209

    Q4210

    Q4211

    Q4214

    Q4215

    Q4216

    Q4217

    Q4218

    Q4219

    Q4220

    Q4221

    Q4222

    Q5116

    Q5117

    Q5118


    EXPERIMENTAL/INVESTIGATIONAL SERVICES

    J7401

    Q4212

    Q4213

    Q4226

    0105U

    0106U

    0107U

    0108U

    0109U

    0110U

    0111U

    0112U

    0113U

    0114U

    0115U

    0116U

    0117U

    0118U

    0119U

    0120U

    0121U

    0122U

    0123U

    0124U

    0125U

    0126U

    0127U

    0128U

    0129U

    0130U

    0131U

    0132U

    0133U

    0134U

    0135U

    0136U

    0137U

    0138U

    Issued on - 10/01/2019


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