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97732f74-96a1-4bb1-afbb-1545f50fc384.aspx
  
08.00.62nAbatacept(Orencia®)forInjectionforIntravenousUse08.00.62nPharmacy (08)Abatacept (Orencia®) for Injection for Intravenous Use97732f74-96a1-4bb1-afbb-1545f50fc3844255Abatacept (Orencia®) for Injection for Intravenous Use08.00.62
{"4256": {"Id":4256,"MPAttachmentLetter":"A","Title":"ICD-10 CODES AND NARRATIVES","MPPolicyAttachmentInternalSourceId":6281,"PolicyAttachmentPageName":"c2a486e7-2984-4e36-ac6e-51e8cf5f261c"},}
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12.00.01gAcupuncture(Independence)12.00.01gMiscellaneous (12)Acupuncture (Independence)151d34b6-4e58-416b-b105-5282cd83c5f43625Acupuncture (Independence)12.00.01
{"3626": {"Id":3626,"MPAttachmentLetter":"A","Title":"ICD-10 CM Codes Eligible to be Reported for Acupuncture","MPPolicyAttachmentInternalSourceId":5770,"PolicyAttachmentPageName":"162a73bf-e53e-4008-9b6f-f3b142e31096"},}
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12.04.04aAcuteCareFacilityInpatientTransfers12.04.04aMiscellaneous (12)Acute Care Facility Inpatient Transfersa26ef448-30db-43ac-94c2-e6d4b2be4b3a3272Acute Care Facility Inpatient Transfers12.04.04
7d2c9273-a6c7-4c55-829b-131f19dcc536.aspx
  
08.01.11gAdo-TrastuzumabEmtansine(Kadcyla®)08.01.11gPharmacy (08)Ado-Trastuzumab Emtansine (Kadcyla®)7d2c9273-a6c7-4c55-829b-131f19dcc5363832Ado-Trastuzumab Emtansine (Kadcyla®)08.01.11
{"3833": {"Id":3833,"MPAttachmentLetter":"A","Title":"ICD-10-CM Codes and Narratives","MPPolicyAttachmentInternalSourceId":5900,"PolicyAttachmentPageName":"cc304fe8-ebb1-430f-921d-46e18337efdd"},}
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08.00.69cAgalsidasebeta(Fabrazyme®)08.00.69cPharmacy (08)Agalsidase beta (Fabrazyme®)8d58c8ea-0ea8-4718-8161-db431f914dfd4113Agalsidase beta (Fabrazyme®)08.00.69
225d3101-03b1-4bcf-bbb9-96b94e93d897.aspx
  
12.04.03cAirAmbulanceServices12.04.03cMiscellaneous (12)Air Ambulance Services225d3101-03b1-4bcf-bbb9-96b94e93d8973340Air Ambulance Services12.04.03
c99cc1c3-d7ce-455d-a834-7e6172ae9fad.aspx
  
08.01.22dAlemtuzumab(Lemtrada®)08.01.22dPharmacy (08)Alemtuzumab (Lemtrada®)c99cc1c3-d7ce-455d-a834-7e6172ae9fad4243Alemtuzumab (Lemtrada®)08.01.22
9aeb8b06-a5ea-47a1-8879-3dca44c51dd9.aspx
  
08.00.72kAlglucosidasealfa(e.g.,Lumizyme®),Avalglucosidasealfa-ngpt(Nexviazyme®)08.00.72kPharmacy (08)Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® )9aeb8b06-a5ea-47a1-8879-3dca44c51dd94204Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® )08.00.72
ed39b1c3-6d7a-468f-a34f-d38ae5a9c7b9.aspx
  
07.00.21jAllergyImmunotherapy07.00.21jMedicine (07)Allergy Immunotherapyed39b1c3-6d7a-468f-a34f-d38ae5a9c7b93158Allergy Immunotherapy07.00.21
87fbd717-0d87-4e63-b5c6-86d241ad32d6.aspx
  
08.01.88AllogeneicProcessedThymusTissue-agdc(Rethymic®)08.01.88Pharmacy (08)Allogeneic Processed Thymus Tissue-agdc (Rethymic®)87fbd717-0d87-4e63-b5c6-86d241ad32d64140Allogeneic Processed Thymus Tissue-agdc (Rethymic®)08.01.88
732b9ea2-3872-424f-a25a-816f8a28c575.aspx
  
06.02.29dAlloMap™MolecularExpressionTestingforHeartTransplantRejection(IndependenceAdministrators)06.02.29dPathology and Laboratory (06)AlloMap™ Molecular Expression Testing for Heart Transplant Rejection (Independence Administrators)732b9ea2-3872-424f-a25a-816f8a28c5754137AlloMap™ Molecular Expression Testing for Heart Transplant Rejection (Independence Administrators)06.02.29
cd609c07-1e33-4d4a-8c08-24fb11b0ecea.aspx
  
08.00.91eAlpha1-AntitrypsinTherapy(e.g.,Prolastin-C®,AralastNP®,Glassia®,Zemaira®)08.00.91ePharmacy (08)Alpha 1-Antitrypsin Therapy (e.g., Prolastin-C®, Aralast NP®, Glassia®, Zemaira®)cd609c07-1e33-4d4a-8c08-24fb11b0ecea4244Alpha 1-Antitrypsin Therapy (e.g., Prolastin-C®, Aralast NP®, Glassia®, Zemaira®)08.00.91
2f22690e-8261-4414-bca3-01ceddede7e3.aspx
  
00.01.52pAlwaysBundledProcedureCodes00.01.52pAdministrative (00)Always Bundled Procedure Codes2f22690e-8261-4414-bca3-01ceddede7e34146Always Bundled Procedure Codes00.01.52
{"4147": {"Id":4147,"MPAttachmentLetter":"B","Title":"Procedures/Services Not Eligible for Separate Reimbursement","MPPolicyAttachmentInternalSourceId":6316,"PolicyAttachmentPageName":"6c897075-52b1-49c0-a174-4907a4ced78b"},"4148": {"Id":4148,"MPAttachmentLetter":"A","Title":"Always Bundled Procedures (Indicator B)","MPPolicyAttachmentInternalSourceId":6317,"PolicyAttachmentPageName":"5dd6d4f1-37a2-4031-836d-6ff892b4c259"},"4149": {"Id":4149,"MPAttachmentLetter":"C","Title":"Procedures/Services Not Eligible for Reimbursement","MPPolicyAttachmentInternalSourceId":6318,"PolicyAttachmentPageName":"ed3fe8f9-32e2-40b7-bfa5-1ba9d7597eb6"},}
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07.02.09gAmbulatoryBloodPressureMonitoring(ABPM)andHomeBloodPressureMonitoring(HBPM)Devices07.02.09gMedicine (07)Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devicesfadd0242-f323-49fe-8ca7-2112b67a09c43006Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices07.02.09
4df933c3-6356-4ea5-b86d-a751cf0ba12b.aspx
  
07.02.21hAmbulatoryElectrocardiography(AECG)MonitoringandMobileCardiacOutpatientTelemetry(MCOT)Monitoring07.02.21hMedicine (07)Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring4df933c3-6356-4ea5-b86d-a751cf0ba12b3909Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring07.02.21
9bdc47f8-e2e3-4abb-9b1d-1d4c1c5e2b74.aspx
  
01.00.12AnesthesiaServicesforEpidural,ParavertebralFacetandSacroiliacJointInjectionsforSpinalJointManagement01.00.12Anesthesia (01)Anesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint Management9bdc47f8-e2e3-4abb-9b1d-1d4c1c5e2b744124Anesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint Management01.00.12
{"4125": {"Id":4125,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":6198,"PolicyAttachmentPageName":"1018d40e-4edc-440c-a9ed-862062e719e4"},}
2fdd9022-2641-49f8-ae4f-b09593402c69.aspx
  
08.01.82bAnifrolumab-fnia(Saphnelo™)08.01.82bPharmacy (08)Anifrolumab-fnia (Saphnelo™)2fdd9022-2641-49f8-ae4f-b09593402c694246Anifrolumab-fnia (Saphnelo™)08.01.82
cf9faf96-487d-47c2-bd76-bc70fd056a33.aspx
  
05.00.39rAnkle-Foot/Knee-Ankle-FootOrthoses05.00.39rDME (05)Ankle-Foot/Knee-Ankle-Foot Orthosescf9faf96-487d-47c2-bd76-bc70fd056a333409Ankle-Foot/Knee-Ankle-Foot Orthoses05.00.39
{"3410": {"Id":3410,"MPAttachmentLetter":"A","Title":"HCPCS Codes","MPPolicyAttachmentInternalSourceId":5437,"PolicyAttachmentPageName":"5f6e2c31-1bcc-46e6-9727-fc05459b2621"},}
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06.03.04nApheresisTherapy06.03.04nPathology and Laboratory (06)Apheresis Therapy36aee0bb-d271-4e94-8256-eafdfce453972774Apheresis Therapy06.03.04
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11.08.05gApplicationandRemovalofTattoos11.08.05gSurgery (11)Application and Removal of Tattoosf0e9fbf8-0357-4a99-8c55-0e6a960173ce4193Application and Removal of Tattoos11.08.05
202addae-a8d3-482f-b7b2-e3af034fa355.aspx
  
08.01.41cAprepitant(Cinvanti™),FosaprepitantDimeglumine(Emend®),Granisetron(Sustol®),andRolapitant(Varubi®)08.01.41cPharmacy (08)Aprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®)202addae-a8d3-482f-b7b2-e3af034fa3553470Aprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®)08.01.41
{"3471": {"Id":3471,"MPAttachmentLetter":"A","Title":"Risk of Emesis Without Prophylaxis: Intravenous and Oral Antineoplastic Agents","MPPolicyAttachmentInternalSourceId":5660,"PolicyAttachmentPageName":"00411fd3-0b49-4077-9c80-e7d25e6698cf"},}
05720d8e-7925-4a18-9aac-a0d2841e1415.aspx
  
11.05.16jAqueousShunts,Microstents,Viscocanalostomy,andCanaloplastyfortheTreatmentofGlaucoma11.05.16jSurgery (11)Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma05720d8e-7925-4a18-9aac-a0d2841e14153947Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma11.05.16
{"3948": {"Id":3948,"MPAttachmentLetter":"A","Title":"ICD-10 codes","MPPolicyAttachmentInternalSourceId":6070,"PolicyAttachmentPageName":"d3ea1441-49e3-40e0-b49c-4e8c06b7da29"},}
b0e984df-bd5e-4e0d-85e6-c2a0b64cb49d.aspx
  
11.14.19pArtificialIntervertebralCervicalDiscInsertion(IndependenceAdministrators)11.14.19pSurgery (11)Artificial Intervertebral Cervical Disc Insertion (Independence Administrators)b0e984df-bd5e-4e0d-85e6-c2a0b64cb49d3704Artificial Intervertebral Cervical  Disc Insertion (Independence Administrators)11.14.19
5d023597-bc1e-40ec-8616-4e86387f03a2.aspx
  
11.15.31ArtificialIntervertebralLumbarDiscInsertion11.15.31Surgery (11)Artificial Intervertebral Lumbar Disc Insertion5d023597-bc1e-40ec-8616-4e86387f03a23666Artificial Intervertebral Lumbar Disc Insertion11.15.31
f3236241-d962-4d30-8d8c-9d77386611ed.aspx
  
08.01.35eAsparaginaseErwiniaChrysanthemi(Erwinaze®),asparaginaseerwiniachrysanthemi(recombinant)-rywn(Rylaze™)08.01.35ePharmacy (08)Asparaginase Erwinia Chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze™)f3236241-d962-4d30-8d8c-9d77386611ed3962Asparaginase Erwinia Chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze™)08.01.35
8948609b-b11b-4d03-9ee4-a40ee508865c.aspx
  
06.02.27nAssaysofGeneticExpressioninTumorTissueforBreastCancerPrognosis(IndependenceAdministrators)06.02.27nPathology and Laboratory (06)Assays of Genetic Expression in Tumor Tissue for Breast Cancer Prognosis (Independence Administrators)8948609b-b11b-4d03-9ee4-a40ee508865c4257Assays of Genetic Expression in Tumor Tissue for Breast Cancer Prognosis (Independence Administrators)06.02.27
a27db102-bd23-420f-a9fd-c5c995a63b0a.aspx
  
07.10.06iAssistedReproductiveTechnologyforInfertilityandOocyteCryopreservation07.10.06iMedicine (07)Assisted Reproductive Technology for Infertility and Oocyte Cryopreservationa27db102-bd23-420f-a9fd-c5c995a63b0a3779Assisted Reproductive Technology for Infertility and Oocyte Cryopreservation07.10.06
676d5b29-8a79-4b13-b40b-0c52774693ce.aspx
  
08.01.69bAtezolizumab(Tecentriq®)08.01.69bPharmacy (08)Atezolizumab (Tecentriq®)676d5b29-8a79-4b13-b40b-0c52774693ce4053Atezolizumab (Tecentriq®)08.01.69
{"4054": {"Id":4054,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":6121,"PolicyAttachmentPageName":"4a76e977-afa9-4a55-b96b-9e0a90236679"},}
c9c7224c-29eb-42be-979a-00752302dd1e.aspx
  
11.14.06jAutologousChondrocyteImplantation(ACI)andOtherCell-basedTreatmentsofFocalArticularCartilageLesions(IndependenceAdministrators)11.14.06jSurgery (11)Autologous Chondrocyte Implantation (ACI) and Other Cell-based Treatments of Focal Articular Cartilage Lesions (Independence Administrators)c9c7224c-29eb-42be-979a-00752302dd1e3734Autologous Chondrocyte Implantation (ACI) and Other Cell-based Treatments of Focal Articular Cartilage Lesions (Independence Administrators)11.14.06
6e37e5d6-bbaf-48fa-a6c3-063563373e0a.aspx
  
05.00.29lAutomaticExternalCardioverterDefibrillators(WearableandNonwearable)05.00.29lDME (05)Automatic External Cardioverter Defibrillators (Wearable and Nonwearable)6e37e5d6-bbaf-48fa-a6c3-063563373e0a3492Automatic External Cardioverter Defibrillators (Wearable and Nonwearable)05.00.29
{"3493": {"Id":3493,"MPAttachmentLetter":"B","Title":"ICD-10 codes used to represent the Nonwearable Automatic External Defibrillator (AED):","MPPolicyAttachmentInternalSourceId":5694,"PolicyAttachmentPageName":"6cb3f087-d8e1-46f2-bb16-e4c0efccf069"},"3494": {"Id":3494,"MPAttachmentLetter":"A","Title":"ICD-10 Codes used to represent the Wearable Automatic External Defibrillator (AED):","MPPolicyAttachmentInternalSourceId":5695,"PolicyAttachmentPageName":"663a7b01-481b-406b-a86b-acc389b6356f"},}
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07.03.23eAutonomicNervousSystemTesting07.03.23eMedicine (07)Autonomic Nervous System Testing99237160-60ae-4321-9d47-6b78214a5cfe4276Autonomic Nervous System Testing07.03.23
24beb3c0-be00-4c64-b472-cc607163e0e4.aspx
  
08.01.64aAvelumab(Bavencio®)08.01.64aPharmacy (08)Avelumab (Bavencio®)24beb3c0-be00-4c64-b472-cc607163e0e43955Avelumab (Bavencio®)08.01.64
{"3956": {"Id":3956,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":6026,"PolicyAttachmentPageName":"5e1d79c5-0a19-44be-aa57-7eec4d94d63c"},}
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11.16.06jBalloonCatheterDilationofSinusOstiaforTreatmentofChronicRhinosinusitis11.16.06jSurgery (11)Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis1823d7f2-68b0-42bc-96f0-91216f11d56c4311Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis11.16.06
e2e22104-ada2-4d84-9c71-c600f1ea170e.aspx
  
11.03.02tBariatricSurgery11.03.02tSurgery (11)Bariatric Surgerye2e22104-ada2-4d84-9c71-c600f1ea170e2791Bariatric Surgery11.03.02
{"2792": {"Id":2792,"MPAttachmentLetter":"A","Title":"Body Mass Index (BMI) Charts","MPPolicyAttachmentInternalSourceId":4907,"PolicyAttachmentPageName":"292a20ba-ec48-442c-a624-40100880cb31"},"2793": {"Id":2793,"MPAttachmentLetter":"B","Title":"Tanner Staging System Criteria for Adolescents","MPPolicyAttachmentInternalSourceId":4908,"PolicyAttachmentPageName":"1b6da816-a2b6-4583-807a-5430c89f8392"},"2794": {"Id":2794,"MPAttachmentLetter":"C","Title":"ICD-10-CM codes","MPPolicyAttachmentInternalSourceId":4909,"PolicyAttachmentPageName":"b9184a36-7491-498e-aac9-ed1933abf92b"},}
2a68daca-621e-4826-8bcf-e5212ad5e2c1.aspx
  
08.01.70bBelantamabmafodotin-blmf(Blenrep)08.01.70bPharmacy (08)Belantamab mafodotin-blmf (Blenrep)2a68daca-621e-4826-8bcf-e5212ad5e2c14215Belantamab mafodotin-blmf (Blenrep)08.01.70
7d21a876-9c51-43f5-b1f2-8eee2bfcf351.aspx
  
08.00.99dBelimumab(Benlysta®)forIntravenousUse08.00.99dPharmacy (08)Belimumab (Benlysta®) for Intravenous Use7d21a876-9c51-43f5-b1f2-8eee2bfcf3514042Belimumab (Benlysta®) for Intravenous Use08.00.99
167886b2-53f9-41fc-9978-48e3b5dcd96c.aspx
  
08.00.66qBevacizumab(Avastin®)andRelatedBiosimilarsForOncologicUse08.00.66qPharmacy (08)Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use167886b2-53f9-41fc-9978-48e3b5dcd96c4044Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use08.00.66
{"4045": {"Id":4045,"MPAttachmentLetter":"A","Title":"Dosing and Frequency Requirements","MPPolicyAttachmentInternalSourceId":6016,"PolicyAttachmentPageName":"82ba5cea-a95c-4307-8f4a-a06badd8c82a"},}
51aaf4af-1813-47af-95b8-8602dee4fdf0.aspx
  
00.10.39oBillingforProfessionalOffice-BasedServicesPerformedinanOutpatientOffice-BasedSettingLocatedwithinaFacilityoronaFacilityCampus00.10.39oAdministrative (00)Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus51aaf4af-1813-47af-95b8-8602dee4fdf03975Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus00.10.39
{"3976": {"Id":3976,"MPAttachmentLetter":"A","Title":"Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus","MPPolicyAttachmentInternalSourceId":6119,"PolicyAttachmentPageName":"9e4f9d52-c926-4fc8-81c9-1f2f4cc888d5"},}
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00.10.38aBillingRequirementsforMultipleBirthsforProfessionalProviders00.10.38aAdministrative (00)Billing Requirements for Multiple Births for Professional Providers7467b7be-328a-4664-89ab-13b4c08598393051Billing Requirements for Multiple Births for Professional Providers00.10.38
{"3052": {"Id":3052,"MPAttachmentLetter":"A","Title":"MULTIPLE BIRTH CODING SCENARIOS FOR DELIVERY OF TWINS WHEN ROUTINE OBSTETRIC (GLOBALE MATERNITY/OBSTETRIC [OB]) CARE WAS PROVIDED","MPPolicyAttachmentInternalSourceId":5340,"PolicyAttachmentPageName":"d157b661-7eea-46ea-ab0f-b6ec2bd15a87"},"3053": {"Id":3053,"MPAttachmentLetter":"B","Title":"MULTIPLE BIRTH CODING SCENARIOS FOR DELIVERY OF TWINS WHEN ANETEPARTUM CARE IS NOT PROVIDED","MPPolicyAttachmentInternalSourceId":5341,"PolicyAttachmentPageName":"5d22c25e-12c7-42e4-a127-e50b59895309"},"3054": {"Id":3054,"MPAttachmentLetter":"C","Title":"CODING SCENARIOS FOR REPORTING HIGH-ORDER MULTIPLE (TRIPLETS, QUADRUPLETS, ETC) BIRTHS WHEN ROUTINE OBSTETRIC (GLOBAL MATERNITY/OBSTETRIC [OB]) CARE WAS PROVIDED","MPPolicyAttachmentInternalSourceId":5342,"PolicyAttachmentPageName":"d0a0d176-67d6-4d41-9e52-2cbec1ebff3d"},"3055": {"Id":3055,"MPAttachmentLetter":"D","Title":"MULTIPLE BIRTH CODING SCENARIOS FOR DELIVERY OF HIGH-ORDER MULTIPLES WHEN ANTEPARTUM CARE IS NOT PROVIDED","MPPolicyAttachmentInternalSourceId":5343,"PolicyAttachmentPageName":"74d58125-3d75-4d7b-8d89-cbaebd03cc03"},}
c953a697-6789-487c-85c5-74cc02b327f3.aspx
  
07.00.01jBiofeedbackTherapy07.00.01jMedicine (07)Biofeedback Therapyc953a697-6789-487c-85c5-74cc02b327f33669Biofeedback Therapy07.00.01
003a2876-c32d-49ee-acdf-0694a0faee57.aspx
  
07.06.03bBioimpedencefortheDetectionofLymphedema07.06.03bMedicine (07)Bioimpedence for the Detection of Lymphedema003a2876-c32d-49ee-acdf-0694a0faee574307Bioimpedence for the Detection of Lymphedema07.06.03
bb4a7aab-8e51-48b8-b70e-d9723cca3441.aspx
  
11.05.02jBlepharoplasty,RepairofBlepharoptosis,RepairofBrowPtosis,andCanthoplasty/Canthopexy11.05.02jSurgery (11)Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and Canthoplasty/Canthopexybb4a7aab-8e51-48b8-b70e-d9723cca34413770Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and Canthoplasty/Canthopexy11.05.02
{"3771": {"Id":3771,"MPAttachmentLetter":"A","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":5915,"PolicyAttachmentPageName":"bb9ab1fd-6bf0-4cdc-9739-4a2c84da817c"},}
92a12a39-2356-431e-9323-ff9db3f3d039.aspx
  
08.01.21eBlinatumomab(Blincyto®)08.01.21ePharmacy (08)Blinatumomab (Blincyto®)92a12a39-2356-431e-9323-ff9db3f3d0394314Blinatumomab (Blincyto®)08.01.21
cc074a4c-e78d-48cd-853e-9f582fa3102a.aspx
  
11.01.06fBone-Anchored(Osseointegrated)HearingAidsandImplantableMiddleEarHearingAids11.01.06fSurgery (11)Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aidscc074a4c-e78d-48cd-853e-9f582fa3102a3984Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids11.01.06
e2d89fb6-24ef-4a16-a953-2d2451aaa404.aspx
  
09.00.04lBoneMineralDensity(BMD)Testing09.00.04lRadiology (09)Bone Mineral Density (BMD) Testinge2d89fb6-24ef-4a16-a953-2d2451aaa4043911Bone Mineral Density (BMD) Testing09.00.04
52b13a0d-045a-4ff0-b2ca-70799840fbe4.aspx
  
08.00.73nBortezomib(BortezomibforInjection,Velcade®)08.00.73nPharmacy (08)Bortezomib (Bortezomib for Injection, Velcade®)52b13a0d-045a-4ff0-b2ca-70799840fbe44127Bortezomib (Bortezomib for Injection, Velcade®)08.00.73
{"4128": {"Id":4128,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":6196,"PolicyAttachmentPageName":"c0c4029d-6756-48a1-8034-abe6354ac88e"},}
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4cb3894b-2c2b-4737-a0c4-1ba6c6a65167.aspx
  
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{"3673": {"Id":3673,"MPAttachmentLetter":"A","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":5729,"PolicyAttachmentPageName":"9edc8373-3d61-4d0c-9158-b0716b073418"},}
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{"4300": {"Id":4300,"MPAttachmentLetter":"A","Title":"Procedure Codes Related to Cast and Splint Applications and Associated Supplies","MPPolicyAttachmentInternalSourceId":6421,"PolicyAttachmentPageName":"ef40cfc7-9301-40ac-955b-042c21374443"},}
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{"3933": {"Id":3933,"MPAttachmentLetter":"A","Title":"ICD 10 codes for policy 11.01.07d, Cataract Surgery","MPPolicyAttachmentInternalSourceId":6072,"PolicyAttachmentPageName":"599939d0-daf9-4f13-8d68-e4a1412ea6d6"},}
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{"3924": {"Id":3924,"MPAttachmentLetter":"A","Title":"ICD-10 CODES AND NARRATIVES","MPPolicyAttachmentInternalSourceId":6115,"PolicyAttachmentPageName":"699d305b-2a53-480e-a300-2ca122f8de0d"},}
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{"3842": {"Id":3842,"MPAttachmentLetter":"A","Title":"MEDICALLY NECESSARY ICD 10 CODES FOR COBALAMIN (VITAMIN B12) AND/OR FOLIC ACID TESTING (CPT CODES 82607, 82608, 82746, AND 82747)","MPPolicyAttachmentInternalSourceId":6108,"PolicyAttachmentPageName":"8bfa343e-fd32-44e5-bb8b-2708d310b6e4"},}
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