Medicare Advantage
Advanced Search
Type
  
Name
  
ID
  
MPDispTitle
  
Policy Category
  
MPPolicyNumber
  
MPPolicyNumberwithoutversion
  
MPPolicyPageName
  
MPTitle
  
Title
  
MPattachmentdataPub
Checked Out To
  
ed3c630c-1626-4ad7-995c-66360af7d2de.aspx
  
5748Abatacept(Orencia®)forInjectionforIntravenousUseMA08.028jPharmacy (08)MA08.028jMA08.028ed3c630c-1626-4ad7-995c-66360af7d2deAbatacept (Orencia®) for Injection for Intravenous UseAbatacept (Orencia®) for Injection for Intravenous Use
{"5749": {"Id":5749,"MPAttachmentLetter":"A","Title":"ICD-10 codes","MPPolicyAttachmentInternalSourceId":8939,"PolicyAttachmentPageName":"c2e0cbcc-998c-429c-8758-255709a5df24"},}
5247f0d8-bd39-40b9-8d10-0dbf4ddd71c3.aspx
  
6204AbortionMA11.010dSurgery (11)MA11.010dMA11.0105247f0d8-bd39-40b9-8d10-0dbf4ddd71c3AbortionAbortion
7b7d21d8-995e-4f47-ba27-8a8ab16dd472.aspx
  
6197AcupunctureMA12.004eMiscellaneous (12)MA12.004eMA12.0047b7d21d8-995e-4f47-ba27-8a8ab16dd472AcupunctureAcupuncture
{"6198": {"Id":6198,"MPAttachmentLetter":"A","Title":"ICD-10 CM Codes Eligible to be Reported for Acupuncture","MPPolicyAttachmentInternalSourceId":9447,"PolicyAttachmentPageName":"211cfe61-db67-4e17-95a7-67cf12e61ea8"},}
0809d82e-8341-423b-aeed-cce7da5a3823.aspx
  
5388AcuteCareFacilityInpatientTransfersMA12.003bMiscellaneous (12)MA12.003bMA12.0030809d82e-8341-423b-aeed-cce7da5a3823Acute Care Facility Inpatient TransfersAcute Care Facility Inpatient Transfers
0427c16c-df82-4cc6-90c0-d2f189ee43da.aspx
  
5673ADAMTS13,recombinant-krhn(Adzynma)MA08.171Pharmacy (08)MA08.171MA08.1710427c16c-df82-4cc6-90c0-d2f189ee43daADAMTS13, recombinant-krhn (Adzynma)ADAMTS13, recombinant-krhn (Adzynma)
db6e085d-3e46-4bde-b37c-672c6dcdba72.aspx
  
5272Ado-TrastuzumabEmtansine(Kadcyla®)MA08.066gPharmacy (08)MA08.066gMA08.066db6e085d-3e46-4bde-b37c-672c6dcdba72Ado-Trastuzumab Emtansine (Kadcyla®)Ado-Trastuzumab Emtansine (Kadcyla®)
{"5273": {"Id":5273,"MPAttachmentLetter":"A","Title":"ICD-10 CODES AND NARRATIVES","MPPolicyAttachmentInternalSourceId":8440,"PolicyAttachmentPageName":"45854213-f098-424b-a721-2312eddd195d"},}
a7f7e4c6-301e-468f-99c7-74ba75edfdea.aspx
  
5720Agalsidasebeta(Fabrazyme)andpegunigalsidasealfa-iwxj(Elfabrio)MA08.033dPharmacy (08)MA08.033dMA08.033a7f7e4c6-301e-468f-99c7-74ba75edfdeaAgalsidase beta (Fabrazyme) and pegunigalsidase alfa-iwxj (Elfabrio)Agalsidase beta (Fabrazyme) and pegunigalsidase alfa-iwxj (Elfabrio)
420ad8fb-7e35-42ef-bc80-342ad110b9c7.aspx
  
5566AirAmbulanceServicesMA12.007bMiscellaneous (12)MA12.007bMA12.007420ad8fb-7e35-42ef-bc80-342ad110b9c7Air Ambulance ServicesAir Ambulance Services
103fbbfd-a56d-439c-abf3-6b542da61c90.aspx
  
6312Alemtuzumab(Lemtrada®)MA08.015dPharmacy (08)MA08.015dMA08.015103fbbfd-a56d-439c-abf3-6b542da61c90Alemtuzumab (Lemtrada®)Alemtuzumab (Lemtrada®)
3e58f2d7-3d82-4290-9777-c24b06b56b8b.aspx
  
5412Alglucosidasealfa(e.g.,Lumizyme®),Avalglucosidasealfa-ngpt(Nexviazyme®),Cipaglucosidasealfa-atga(Pombiliti™)MA08.036gPharmacy (08)MA08.036gMA08.0363e58f2d7-3d82-4290-9777-c24b06b56b8bAlglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ), Cipaglucosidase alfa-atga (Pombiliti™ )Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ), Cipaglucosidase alfa-atga (Pombiliti™ )
f13596c2-d792-4dd5-8c42-1aa95d5da992.aspx
  
5442AllergyImmunotherapyMA07.055dMedicine (07)MA07.055dMA07.055f13596c2-d792-4dd5-8c42-1aa95d5da992Allergy ImmunotherapyAllergy Immunotherapy
04f53e63-b505-4577-a720-9cdd08902e6c.aspx
  
5429Alpha1-AntitrypsinTherapy(e.g.,Prolastin-C,AralastNP,Glassia,Zemaira)MA08.050bPharmacy (08)MA08.050bMA08.05004f53e63-b505-4577-a720-9cdd08902e6cAlpha 1-Antitrypsin Therapy (e.g., Prolastin-C, Aralast NP, Glassia, Zemaira)Alpha 1-Antitrypsin Therapy (e.g., Prolastin-C, Aralast NP, Glassia, Zemaira)
732a16ff-a2c2-4296-b230-6f4940443052.aspx
  
6178AlwaysBundledProcedureCodesMA00.026wAdministrative (00)MA00.026wMA00.026732a16ff-a2c2-4296-b230-6f4940443052Always Bundled Procedure CodesAlways Bundled Procedure Codes
{"6179": {"Id":6179,"MPAttachmentLetter":"B","Title":"Procedures/Services Not Eligible for Separate Reimbursement","MPPolicyAttachmentInternalSourceId":9403,"PolicyAttachmentPageName":"7a20fdaa-397d-42a4-a1e0-5392f14bfcab"},"6180": {"Id":6180,"MPAttachmentLetter":"A","Title":"Always Bundled Procedures (MPFSD Indicator B)","MPPolicyAttachmentInternalSourceId":9404,"PolicyAttachmentPageName":"6eb35d44-eaeb-4a34-9a65-cb418c58f319"},"6181": {"Id":6181,"MPAttachmentLetter":"C","Title":"Procedures/Services Not Eligible for Reimbursement","MPPolicyAttachmentInternalSourceId":9405,"PolicyAttachmentPageName":"d4b29a36-fe9d-4580-aef6-c14dab634dc0"},}
f1e90256-36b5-4258-a55d-665e0ef0f39b.aspx
  
5245AmbulatoryBloodPressureMonitoring(ABPM)andHomeBloodPressureMonitoring(HBPM)DevicesMA07.005cMedicine (07)MA07.005cMA07.005f1e90256-36b5-4258-a55d-665e0ef0f39bAmbulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) DevicesAmbulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices
2b56e2df-5eb8-4ca2-8ab6-fecf0b08390a.aspx
  
6080AmbulatoryElectrocardiography(AECG)MonitoringandMobileCardiacOutpatientTelemetry(MCOT)MonitoringMA07.026qMedicine (07)MA07.026qMA07.0262b56e2df-5eb8-4ca2-8ab6-fecf0b08390aAmbulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) MonitoringAmbulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring
ccc161f0-a85b-46c5-a2ce-d890adbb7140.aspx
  
5499Amivantamab-vmjw(Rybrevant®)MA08.148aPharmacy (08)MA08.148aMA08.148ccc161f0-a85b-46c5-a2ce-d890adbb7140Amivantamab-vmjw (Rybrevant®)Amivantamab-vmjw (Rybrevant®)
f99aee36-fbda-4446-a2f3-70db6fd879f2.aspx
  
5787AnesthesiaServicesforEpidural,ParavertebralFacetandSacroiliacJointInjectionsforSpinalJointManagementMA01.008cAnesthesia (01)MA01.008cMA01.008f99aee36-fbda-4446-a2f3-70db6fd879f2Anesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint ManagementAnesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint Management
{}
3c8f3bc9-2017-4dea-a268-406350e85081.aspx
  
5555Anifrolumab-fnia(Saphnelo®)MA08.140cPharmacy (08)MA08.140cMA08.1403c8f3bc9-2017-4dea-a268-406350e85081Anifrolumab-fnia (Saphnelo®)Anifrolumab-fnia (Saphnelo®)
f137479a-fe69-4cdf-b5ec-d08175d48f90.aspx
  
6224Ankle-Foot/Knee-Ankle-FootOrthosesMA05.010kDME (05)MA05.010kMA05.010f137479a-fe69-4cdf-b5ec-d08175d48f90Ankle-Foot/Knee-Ankle-Foot OrthosesAnkle-Foot/Knee-Ankle-Foot Orthoses
{"6225": {"Id":6225,"MPAttachmentLetter":"A","Title":"HCPCS CODES FOR ANKLE-FOOT/ KNEE-ANKLE FOOT ORTHOSIS","MPPolicyAttachmentInternalSourceId":9578,"PolicyAttachmentPageName":"31ab838f-0ca4-4060-bbae-9adcb421e90e"},}
d0d7bb75-d040-4b3b-b6b5-8a613cf4e308.aspx
  
6017ApheresisTherapyMA06.001fPathology and Laboratory (06)MA06.001fMA06.001d0d7bb75-d040-4b3b-b6b5-8a613cf4e308Apheresis TherapyApheresis Therapy
2992fac3-dec1-4b89-ad5a-b7da45bad732.aspx
  
5961Apos®biomechanicalshoesystemMA05.070DME (05)MA05.070MA05.0702992fac3-dec1-4b89-ad5a-b7da45bad732Apos® biomechanical shoe systemApos® biomechanical shoe system
2a27f7af-3e2a-4413-932d-11598d28a540.aspx
  
5214ApplicationandRemovalofTattoosMA11.072Surgery (11)MA11.072MA11.0722a27f7af-3e2a-4413-932d-11598d28a540Application and Removal of TattoosApplication and Removal of Tattoos
5d13769e-fdd0-4606-90f0-c33def059482.aspx
  
5507AqueousShunts,Microstents,Viscocanalostomy,andCanaloplastyfortheTreatmentofGlaucomaMA11.105jSurgery (11)MA11.105jMA11.1055d13769e-fdd0-4606-90f0-c33def059482Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of GlaucomaAqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma
{"5508": {"Id":5508,"MPAttachmentLetter":"A","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":8592,"PolicyAttachmentPageName":"3953fbb7-a495-4547-a7fa-21f7fef4d770"},}
8bcf28b4-f8a5-4902-b0c3-4bdde4e1d6d3.aspx
  
6092AsparaginaseErwiniaChrysanthemi(recombinant)-rywn(Rylaze®)MA08.085iPharmacy (08)MA08.085iMA08.0858bcf28b4-f8a5-4902-b0c3-4bdde4e1d6d3Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)
6560da27-3949-4979-9475-d5345f6709fd.aspx
  
6251Atezolizumab(Tecentriq®)andAtezolizumabwithHyaluronidase-tqjs(TecentriqHybrezaTM)MA08.127ePharmacy (08)MA08.127eMA08.1276560da27-3949-4979-9475-d5345f6709fdAtezolizumab (Tecentriq®) and Atezolizumab with Hyaluronidase-tqjs (Tecentriq Hybreza TM)Atezolizumab (Tecentriq®) and Atezolizumab with Hyaluronidase-tqjs (Tecentriq Hybreza TM)
{"6252": {"Id":6252,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":9572,"PolicyAttachmentPageName":"5a99ebdc-e88d-4c81-9731-517a029a4ee0"},}
b09c9dbd-b5a3-4d46-a5fa-27106de7f0e4.aspx
  
5496AuricularProsthesesMA05.068DME (05)MA05.068MA05.068b09c9dbd-b5a3-4d46-a5fa-27106de7f0e4Auricular ProsthesesAuricular Prostheses
cffb659e-3516-4ed5-9fd5-8c32ce9b3cf8.aspx
  
6289AutomaticExternalCardioverterDefibrillators(WearableandNonwearable)MA05.005gDME (05)MA05.005gMA05.005cffb659e-3516-4ed5-9fd5-8c32ce9b3cf8Automatic External Cardioverter Defibrillators (Wearable and Nonwearable)Automatic External Cardioverter Defibrillators (Wearable and Nonwearable)
{"6290": {"Id":6290,"MPAttachmentLetter":"B","Title":"ICD-10 codes used to represent the Nonwearable Automatic External Defibrillator (AED):","MPPolicyAttachmentInternalSourceId":9498,"PolicyAttachmentPageName":"62b77d29-4e7a-4d8f-b57d-423887310236"},"6291": {"Id":6291,"MPAttachmentLetter":"A","Title":"ICD-10 codes used to represent the Wearable Automatic External Defibrillator (AED):","MPPolicyAttachmentInternalSourceId":9499,"PolicyAttachmentPageName":"f664c93f-fe72-4409-b658-dd0db8848e62"},}
e70e8384-b042-448a-9093-7b25f74c2cd1.aspx
  
5800AutonomicNervousSystemTestingMA07.027gMedicine (07)MA07.027gMA07.027e70e8384-b042-448a-9093-7b25f74c2cd1Autonomic Nervous System TestingAutonomic Nervous System Testing
90599aed-a4fc-4780-9d15-20a3812c5918.aspx
  
6040Avelumab(Bavencio®)MA08.122dPharmacy (08)MA08.122dMA08.12290599aed-a4fc-4780-9d15-20a3812c5918Avelumab (Bavencio®)Avelumab (Bavencio®)
{"6041": {"Id":6041,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":9268,"PolicyAttachmentPageName":"982e11ee-7966-4d81-919f-d89864ce4a94"},}
df59f2ba-1771-49f9-804f-1df634450e92.aspx
  
6295BalloonCatheterDilationofSinusOstiaforTreatmentofChronicRhinosinusitisorRecurrentAcuteRhinosinusitisMA11.100fSurgery (11)MA11.100fMA11.100df59f2ba-1771-49f9-804f-1df634450e92Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis or Recurrent Acute Rhinosinusitis Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis or Recurrent Acute Rhinosinusitis
3fc29fb9-fa26-4104-a1d4-e262c84ad84d.aspx
  
5487Belimumab(Benlysta®)forIntravenousUseMA08.057dPharmacy (08)MA08.057dMA08.0573fc29fb9-fa26-4104-a1d4-e262c84ad84dBelimumab (Benlysta®) for Intravenous UseBelimumab (Benlysta®) for Intravenous Use
ce66cb81-3ff6-42ac-af66-2776777cd735.aspx
  
6022Bevacizumab(Avastin®)andRelatedBiosimilarsForOncologicUseMA08.072oPharmacy (08)MA08.072oMA08.072ce66cb81-3ff6-42ac-af66-2776777cd735Bevacizumab (Avastin®) and Related Biosimilars For Oncologic UseBevacizumab (Avastin®) and Related Biosimilars For Oncologic Use
{"6023": {"Id":6023,"MPAttachmentLetter":"A","Title":"ICD 10 Diagnosis Codes","MPPolicyAttachmentInternalSourceId":9219,"PolicyAttachmentPageName":"24114252-7a31-479e-8b76-9b42de76b943"},}
08871161-cc0f-4de0-a470-8235bd519596.aspx
  
6137BillingforProfessionalOffice-BasedServicesPerformedinanOutpatientOffice-BasedSettingLocatedwithinaFacilityoronaFacilityCampusMA00.037mAdministrative (00)MA00.037mMA00.03708871161-cc0f-4de0-a470-8235bd519596Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility CampusBilling for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
{"6138": {"Id":6138,"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 - CPT/HCPCS Codes","MPPolicyAttachmentInternalSourceId":9410,"PolicyAttachmentPageName":"63987a25-f187-456e-8770-7dd80adca0e4"},}
287956eb-e6fa-4e31-b950-8f115705c651.aspx
  
6309BiofeedbackTherapyMA07.010cMedicine (07)MA07.010cMA07.010287956eb-e6fa-4e31-b950-8f115705c651Biofeedback TherapyBiofeedback Therapy
3618f5bc-f6a6-4f0e-8b86-e3a09e24aef5.aspx
  
5710BioimpedancefortheDetectionofLymphedemaMA07.052Medicine (07)MA07.052MA07.0523618f5bc-f6a6-4f0e-8b86-e3a09e24aef5Bioimpedance for the Detection of LymphedemaBioimpedance for the Detection of Lymphedema
aa1882f6-fa76-4f43-bfb6-2d251bb92d33.aspx
  
5951Blinatumomab(Blincyto®)MA08.058gPharmacy (08)MA08.058gMA08.058aa1882f6-fa76-4f43-bfb6-2d251bb92d33Blinatumomab (Blincyto®) Blinatumomab (Blincyto®)
1942af87-90e8-4c5d-b178-fbf39aafdedb.aspx
  
5408Bone-Anchored(Osseointegrated)HearingAidsandImplantableMiddleEarHearingAidsMA11.049gSurgery (11)MA11.049gMA11.0491942af87-90e8-4c5d-b178-fbf39aafdedbBone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing AidsBone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids
e88cddc6-75a0-4770-9147-d8832a0ba990.aspx
  
5470BotulinumToxinAgentsMA08.017kPharmacy (08)MA08.017kMA08.017e88cddc6-75a0-4770-9147-d8832a0ba990Botulinum Toxin AgentsBotulinum Toxin Agents
{"5471": {"Id":5471,"MPAttachmentLetter":"A","Title":"ICD-10 Diagnosis Codes","MPPolicyAttachmentInternalSourceId":8526,"PolicyAttachmentPageName":"61e7ac61-33bb-4c11-9ee1-7c92f0dc1a09"},}
7d0b88ab-df5b-48bf-b706-ddcfbfb32220.aspx
  
5968BrentuximabVedotin(Adcetris®)MA08.068kPharmacy (08)MA08.068kMA08.0687d0b88ab-df5b-48bf-b706-ddcfbfb32220Brentuximab Vedotin (Adcetris®)Brentuximab Vedotin (Adcetris®)
{"5969": {"Id":5969,"MPAttachmentLetter":"A","Title":"ICD 10 CODES AND NARRATIVES","MPPolicyAttachmentInternalSourceId":9002,"PolicyAttachmentPageName":"f839ac09-9f40-4275-9d8f-2908de3953e0"},}
3fcc7ddf-57aa-46dc-ad3a-862150ec9635.aspx
  
6191BronchialValvesMA11.020Surgery (11)MA11.020MA11.0203fcc7ddf-57aa-46dc-ad3a-862150ec9635Bronchial ValvesBronchial Valves
34ff3ea5-f3a5-44fa-a9c6-578d1fe08c02.aspx
  
5443Burosumab-twza(Crysvita®)MA08.099bPharmacy (08)MA08.099bMA08.09934ff3ea5-f3a5-44fa-a9c6-578d1fe08c02Burosumab-twza (Crysvita®)Burosumab-twza (Crysvita®)
c369338c-9e54-4e41-93f5-8ab849749d7b.aspx
  
6027Canakinumab(Ilaris®)MA08.101cPharmacy (08)MA08.101cMA08.101c369338c-9e54-4e41-93f5-8ab849749d7bCanakinumab (Ilaris®)Canakinumab (Ilaris®)
{"6028": {"Id":6028,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":9271,"PolicyAttachmentPageName":"8c9631c0-b1c0-4c07-a575-a720542b2064"},}
ce3cfd1e-4c67-4ca8-817e-690ac71d2f34.aspx
  
5185CanesandCrutchesMA05.052bDME (05)MA05.052bMA05.052ce3cfd1e-4c67-4ca8-817e-690ac71d2f34Canes and CrutchesCanes and Crutches
5fb9f4ac-c527-472a-b667-a78635412888.aspx
  
5204CapsuleEndoscopyMA07.022eMedicine (07)MA07.022eMA07.0225fb9f4ac-c527-472a-b667-a78635412888Capsule EndoscopyCapsule Endoscopy
7e41ed3b-88ee-4c91-a965-9e4bf3f8f53c.aspx
  
6296CardiacRehabilitation(CR)andIntensiveCardiacRehabilitation(ICR)ProgramsMA10.002fRehabilitation Services (10)MA10.002fMA10.0027e41ed3b-88ee-4c91-a965-9e4bf3f8f53cCardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) ProgramsCardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs
{"6297": {"Id":6297,"MPAttachmentLetter":"A","Title":"Medically Necessary ICD-10 Codes","MPPolicyAttachmentInternalSourceId":9407,"PolicyAttachmentPageName":"ad37198a-7c92-4132-a342-207fad8df7fa"},}
6a20c776-d2e0-4b6a-b1a0-e33b11f3e83e.aspx
  
6126CareManagementandCarePlanningServicesMA00.006oAdministrative (00)MA00.006oMA00.0066a20c776-d2e0-4b6a-b1a0-e33b11f3e83eCare Management and Care Planning ServicesCare Management and Care Planning Services
155edd3e-ea48-4911-983c-324bd536b3ec.aspx
  
5967Carfilzomib(Kyprolis®)MA08.062jPharmacy (08)MA08.062jMA08.062155edd3e-ea48-4911-983c-324bd536b3ecCarfilzomib (Kyprolis®)Carfilzomib (Kyprolis®)
38b84f55-c5c3-47ea-94a7-daf68ce3bd93.aspx
  
5739CastandSplintApplicationsandAssociatedSuppliesMA00.012cAdministrative (00)MA00.012cMA00.01238b84f55-c5c3-47ea-94a7-daf68ce3bd93Cast and Splint Applications and Associated SuppliesCast and Splint Applications and Associated Supplies
{"5740": {"Id":5740,"MPAttachmentLetter":"A","Title":"Procedures Related to Cast and Splint Applications and Associated Supplies","MPPolicyAttachmentInternalSourceId":8998,"PolicyAttachmentPageName":"a49d93ab-d66a-4ada-ac9c-5ff32d7a768f"},}
e5472b5f-bca0-453a-b369-550a15224d67.aspx
  
5556CataractSurgeryMA11.054eSurgery (11)MA11.054eMA11.054e5472b5f-bca0-453a-b369-550a15224d67Cataract SurgeryCataract Surgery
{"5557": {"Id":5557,"MPAttachmentLetter":"A","Title":"ICD-10 codes","MPPolicyAttachmentInternalSourceId":8500,"PolicyAttachmentPageName":"8ef8ebd8-c48d-4da6-8a52-287b59e49e6a"},}
2ae5bad1-37de-4475-8d99-846693d71314.aspx
  
6071CatheterAblationofCardiacArrhythmiasMA11.060hSurgery (11)MA11.060hMA11.0602ae5bad1-37de-4475-8d99-846693d71314Catheter Ablation of Cardiac ArrhythmiasCatheter Ablation of Cardiac Arrhythmias
6c6e10dc-ecd9-4e00-b4d1-b6751f02ea6e.aspx
  
5972Cemiplimab-rwlc(Libtayo®)MA08.124dPharmacy (08)MA08.124dMA08.1246c6e10dc-ecd9-4e00-b4d1-b6751f02ea6eCemiplimab-rwlc (Libtayo®)Cemiplimab-rwlc (Libtayo®)
8fcdb3f7-853b-4fbb-8057-963814d748b2.aspx
  
5989Cerliponasealfa(Brineura®)MA08.089dPharmacy (08)MA08.089dMA08.0898fcdb3f7-853b-4fbb-8057-963814d748b2Cerliponase alfa (Brineura®)Cerliponase alfa (Brineura®)
{"5990": {"Id":5990,"MPAttachmentLetter":"A","Title":"Dosing and Frequency Requirements for Cerliponase alfa (Brineura®)","MPPolicyAttachmentInternalSourceId":9270,"PolicyAttachmentPageName":"890e5ece-e4ab-4af7-8599-be42336ba34e"},}
8d61db11-c756-41ef-867e-e009a28095f8.aspx
  
6030CervicalTractionDevicesforIn-homeUseMA05.009bDME (05)MA05.009bMA05.0098d61db11-c756-41ef-867e-e009a28095f8Cervical Traction Devices for In-home UseCervical Traction Devices for In-home Use
38e8f5e0-eab4-421d-a5b3-807ff85010d8.aspx
  
5235Cetuximab(Erbitux®)MA08.031gPharmacy (08)MA08.031gMA08.03138e8f5e0-eab4-421d-a5b3-807ff85010d8Cetuximab (Erbitux®)Cetuximab (Erbitux®)
{"5236": {"Id":5236,"MPAttachmentLetter":"B","Title":"ICD-10 Codes for Cetuximab (Erbitux®)","MPPolicyAttachmentInternalSourceId":8348,"PolicyAttachmentPageName":"34a06c92-ef49-4d9f-b25f-d1a9fd32765d"},"5237": {"Id":5237,"MPAttachmentLetter":"A","Title":"Dosing and Frequency Requirements","MPPolicyAttachmentInternalSourceId":8349,"PolicyAttachmentPageName":"e81566f9-1b58-46db-95dc-0da78e048d74"},}
2dc8c58c-7643-4eba-a338-b2d80596fb58.aspx
  
5845ChemicalPeelsMA11.103bSurgery (11)MA11.103bMA11.1032dc8c58c-7643-4eba-a338-b2d80596fb58Chemical PeelsChemical Peels
04f53427-7c90-4180-a350-b7d6bf21975c.aspx
  
6176ChimericAntigenReceptor(CAR)TherapyMA08.093pPharmacy (08)MA08.093pMA08.09304f53427-7c90-4180-a350-b7d6bf21975cChimeric Antigen Receptor (CAR) TherapyChimeric Antigen Receptor (CAR) Therapy
d8e2b395-3c2b-4f7c-b2eb-5ea5ba4adc87.aspx
  
6271ChiropracticServicesMA10.004iRehabilitation Services (10)MA10.004iMA10.004d8e2b395-3c2b-4f7c-b2eb-5ea5ba4adc87Chiropractic ServicesChiropractic Services
a2360a7e-006e-4403-bc6b-5ab0e276d826.aspx
  
6254CoagulationFactorsMA08.004xPharmacy (08)MA08.004xMA08.004a2360a7e-006e-4403-bc6b-5ab0e276d826Coagulation FactorsCoagulation Factors
3043586c-7729-4aee-af43-8223b5080cb1.aspx
  
5630Cobalamin(VitaminB12),FolicAcid,andHomocysteineTestingMA06.032aPathology and Laboratory (06)MA06.032aMA06.0323043586c-7729-4aee-af43-8223b5080cb1Cobalamin (Vitamin B12), Folic Acid, and Homocysteine TestingCobalamin (Vitamin B12), Folic Acid, and Homocysteine Testing
{"5631": {"Id":5631,"MPAttachmentLetter":"A","Title":"ICD 10 CODES FOR MEDICALLY NECESSARY COBALAMIN (VITAMIN B12), FOLIC ACID, AND/OR HOMOCYSTEINE TESTING (CPT CODES 82607, 82746, AND 83090)","MPPolicyAttachmentInternalSourceId":8881,"PolicyAttachmentPageName":"52256419-fadb-4f99-a259-45f33eddac58"},}
2242f0e2-f338-4f50-837e-1a9ae63f3bd9.aspx
  
6281CochlearImplantationMA11.039eSurgery (11)MA11.039eMA11.0392242f0e2-f338-4f50-837e-1a9ae63f3bd9Cochlear ImplantationCochlear Implantation
a7b81ecf-cefa-42a8-aa7c-f728507035ba.aspx
  
5216Collagenaseclostridiumhistolyticum(Xiaflex®),collagenaseclostridiumhistolyticum-aaes(Qwo®)MA08.128Pharmacy (08)MA08.128MA08.128a7b81ecf-cefa-42a8-aa7c-f728507035baCollagenase clostridium histolyticum ( Xiaflex ®), collagenase clostridium histolyticum-aaes (Qwo®)Collagenase clostridium histolyticum ( Xiaflex ®), collagenase clostridium histolyticum-aaes (Qwo®)
6536528d-3a29-42cc-a5ba-3bdca5c484eb.aspx
  
5199CommodeChairsMA05.036bDME (05)MA05.036bMA05.0366536528d-3a29-42cc-a5ba-3bdca5c484ebCommode ChairsCommode Chairs
0ebbc2e0-fe75-4e98-bc5c-e967fbbc79bc.aspx
  
5483ComplementaryandIntegrativeHealthServicesMA12.001eMiscellaneous (12)MA12.001eMA12.0010ebbc2e0-fe75-4e98-bc5c-e967fbbc79bcComplementary and Integrative Health ServicesComplementary and Integrative Health Services
2dc7ef49-ee37-4af7-81c0-6650851063d7.aspx
  
5663CompleteDecongestiveTherapy(CDT)MA07.042Medicine (07)MA07.042MA07.0422dc7ef49-ee37-4af7-81c0-6650851063d7Complete Decongestive Therapy (CDT)Complete Decongestive Therapy (CDT)
f88af933-9425-4295-b8c3-5209c77615f8.aspx
  
5339CompositeTissueAllotransplantationoftheHand(s)andFaceMA11.112Surgery (11)MA11.112MA11.112f88af933-9425-4295-b8c3-5209c77615f8Composite Tissue Allotransplantation of the Hand(s) and FaceComposite Tissue Allotransplantation of the Hand(s) and Face
80f2b6fc-20b2-4f12-9fdc-9714482a2e4d.aspx
  
6332CompressionGarmentsMA05.045fDME (05)MA05.045fMA05.04580f2b6fc-20b2-4f12-9fdc-9714482a2e4dCompression GarmentsCompression Garments
4f5010c1-eb95-4812-9992-0ce69f694fcd.aspx
  
5718Computer-AidedDetection(CAD)SystemforUsewithChestRadiographsMA09.014bRadiology (09)MA09.014bMA09.0144f5010c1-eb95-4812-9992-0ce69f694fcdComputer-Aided Detection (CAD) System for Use with Chest RadiographsComputer-Aided Detection (CAD) System for Use with Chest Radiographs
bba5081d-4c80-4f43-bdfa-e81babdc9b90.aspx
  
5244Computer-AssistedMusculoskeletalSurgicalNavigationalOrthopedicProcedureMA11.088cSurgery (11)MA11.088cMA11.088bba5081d-4c80-4f43-bdfa-e81babdc9b90Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic ProcedureComputer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure
69d6946a-3b6c-4b70-aa82-23b993e2e391.aspx
  
5490ConsultationServicesMA00.049bAdministrative (00)MA00.049bMA00.04969d6946a-3b6c-4b70-aa82-23b993e2e391Consultation ServicesConsultation Services
dbf50910-cde7-4121-8660-40205dae537b.aspx
  
6232ContinuousGlucoseMonitorsandHomeBloodGlucoseMonitorsandSuppliesMA00.002rAdministrative (00)MA00.002rMA00.002dbf50910-cde7-4121-8660-40205dae537bContinuous Glucose Monitors and Home Blood Glucose Monitors and SuppliesContinuous Glucose Monitors and Home Blood Glucose Monitors and Supplies
{"6233": {"Id":6233,"MPAttachmentLetter":"B","Title":"Implantable Continuous Glucose Monitors (I-CGM)","MPPolicyAttachmentInternalSourceId":9563,"PolicyAttachmentPageName":"420c31fe-e35c-41c8-b54a-bca352cfd419"},"6234": {"Id":6234,"MPAttachmentLetter":"A","Title":"ICD10: Long-Term Interstitial CGMS (Non-Implantable)","MPPolicyAttachmentInternalSourceId":9564,"PolicyAttachmentPageName":"cf29959b-5847-4105-a7b1-798cde885d55"},}
af6f9598-ef4d-4b6d-9a46-e279494ba233.aspx
  
6199ContrastAgentsUsedinConjunctionwithEchocardiographyMA09.004cRadiology (09)MA09.004cMA09.004af6f9598-ef4d-4b6d-9a46-e279494ba233Contrast Agents Used in Conjunction with EchocardiographyContrast Agents Used in Conjunction with Echocardiography
3b3366a5-93c9-473f-a7c6-e4e5c014d21c.aspx
  
5581CornealPachymetryUsingUltrasoundMA07.046gMedicine (07)MA07.046gMA07.0463b3366a5-93c9-473f-a7c6-e4e5c014d21cCorneal Pachymetry Using UltrasoundCorneal Pachymetry Using Ultrasound
{"5582": {"Id":5582,"MPAttachmentLetter":"A","Title":"ICD-10-CM Codes Eligible to be Reported for Corneal Pachymetry Using Ultrasound","MPPolicyAttachmentInternalSourceId":8840,"PolicyAttachmentPageName":"84aa1788-8469-4622-a749-9b4952ea5e26"},}
0713198e-fb30-4e6a-8ccd-3eb4697b63d9.aspx
  
6132CosmeticProceduresMA12.009aMiscellaneous (12)MA12.009aMA12.0090713198e-fb30-4e6a-8ccd-3eb4697b63d9Cosmetic ProceduresCosmetic Procedures
0e3e858b-54b3-41e4-812b-9a87aec99862.aspx
  
5925CoverageofMedicalDevicesMA05.040bDME (05)MA05.040bMA05.0400e3e858b-54b3-41e4-812b-9a87aec99862Coverage of Medical DevicesCoverage of Medical Devices
006edde1-4274-4bea-be2e-c0a7902bdcf7.aspx
  
5548CranialElectrotherapyStimulationMA05.066dDME (05)MA05.066dMA05.066006edde1-4274-4bea-be2e-c0a7902bdcf7Cranial Electrotherapy StimulationCranial Electrotherapy Stimulation
212f9bb9-4a61-4ee2-857a-5191346a270b.aspx
  
5974CriteriaforReimbursementofEmergencyRoomServicesMA00.044dAdministrative (00)MA00.044dMA00.044212f9bb9-4a61-4ee2-857a-5191346a270bCriteria for Reimbursement of Emergency Room ServicesCriteria for Reimbursement of Emergency Room Services
5b7afd00-4a72-4163-9941-435cca4c8a55.aspx
  
5513crizanlizumab-tmca(Adakveo®) MA08.109bPharmacy (08)MA08.109bMA08.1095b7afd00-4a72-4163-9941-435cca4c8a55crizanlizumab-tmca (Adakveo®) crizanlizumab-tmca (Adakveo®)
66c2c56b-86d8-4223-b379-720a7bb9b60d.aspx
  
6021Crovalimab-akkz(PiaSky)MA08.178Pharmacy (08)MA08.178MA08.17866c2c56b-86d8-4223-b379-720a7bb9b60dCrovalimab-akkz (PiaSky) Crovalimab-akkz (PiaSky)
c678248d-0daf-4096-8915-d70396fb9896.aspx
  
6314CryosurgicalAblationoftheProstateGlandMA11.022aSurgery (11)MA11.022aMA11.022c678248d-0daf-4096-8915-d70396fb9896Cryosurgical Ablation of the Prostate GlandCryosurgical Ablation of the Prostate Gland
76d7e222-b0af-498e-a6e5-741733b439ea.aspx
  
5694Daratumumab(Darzalex®),DaratumumabandHyaluronidase-fihj(DarzalexFaspro®)MA08.079lPharmacy (08)MA08.079lMA08.07976d7e222-b0af-498e-a6e5-741733b439eaDaratumumab (Darzalex®), Daratumumab and Hyaluronidase-fihj (Darzalex Faspro®)Daratumumab (Darzalex®), Daratumumab and Hyaluronidase-fihj (Darzalex Faspro®)
ae3916d9-607b-4850-9ae3-fdf1b27d2dda.aspx
  
5896DayRehabilitationMA10.005bRehabilitation Services (10)MA10.005bMA10.005ae3916d9-607b-4850-9ae3-fdf1b27d2ddaDay RehabilitationDay Rehabilitation
0b0d1e52-53a1-4fed-932c-2b07f2810e13.aspx
  
6282DebridementofMycoticandSymptomaticNon-MycoticHypertrophicToeNailsMA11.014gSurgery (11)MA11.014gMA11.0140b0d1e52-53a1-4fed-932c-2b07f2810e13Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe NailsDebridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails
{"6283": {"Id":6283,"MPAttachmentLetter":"E","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (S86.892A - Z79.01), Continued","MPPolicyAttachmentInternalSourceId":9491,"PolicyAttachmentPageName":"7594d6aa-7427-4ca6-ad81-56db5840e982"},"6284": {"Id":6284,"MPAttachmentLetter":"A","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (A30.0 -E10.21)","MPPolicyAttachmentInternalSourceId":9492,"PolicyAttachmentPageName":"65a4550b-2b1e-4ee0-ac3e-f8a618e732b9"},"6285": {"Id":6285,"MPAttachmentLetter":"B","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (E10.22 - E13.3512), Continued","MPPolicyAttachmentInternalSourceId":9493,"PolicyAttachmentPageName":"2cf768f2-05e5-495f-8b89-1306f7ae3426"},"6286": {"Id":6286,"MPAttachmentLetter":"D","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (I87.099 - S86.891S), Continued","MPPolicyAttachmentInternalSourceId":9494,"PolicyAttachmentPageName":"9fd29c32-b9ae-41b6-9bbf-ea0c4c0ef073"},"6287": {"Id":6287,"MPAttachmentLetter":"C","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (E13.3513 - I87.093), Continued","MPPolicyAttachmentInternalSourceId":9495,"PolicyAttachmentPageName":"ae5c2240-b7f9-4fae-96ec-6ed24624fcd4"},}
b49ab836-c598-40c4-a5a4-3ddcfd7c2788.aspx
  
5448DeepBrainStimulation(DBS)MA11.005hSurgery (11)MA11.005hMA11.005b49ab836-c598-40c4-a5a4-3ddcfd7c2788Deep Brain Stimulation (DBS)Deep Brain Stimulation (DBS)
64b2f578-f133-41e3-b498-114278be19ad.aspx
  
6174Denosumab(Prolia®,Xgeva®)andrelatedbiosimilars,andRomosozumab-aqqg(Evenity®)MA08.052nPharmacy (08)MA08.052nMA08.05264b2f578-f133-41e3-b498-114278be19adDenosumab (Prolia®, Xgeva®) and related biosimilars, and Romosozumab-aqqg (Evenity®) Denosumab (Prolia®, Xgeva®) and related biosimilars, and Romosozumab-aqqg (Evenity®)
{"6175": {"Id":6175,"MPAttachmentLetter":"A","Title":"ICD-10-CM Codes","MPPolicyAttachmentInternalSourceId":9286,"PolicyAttachmentPageName":"f337e06e-59a3-4ef5-b319-d69f2ced26b8"},}
e0f7fea6-e4d6-4818-989d-b4211c299401.aspx
  
5792DermabrasionforRhinophyma,Septoplasty,Rhinoplasty,andSeptorhinoplastyMA11.099eSurgery (11)MA11.099eMA11.099e0f7fea6-e4d6-4818-989d-b4211c299401Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and SeptorhinoplastyDermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty
7393357c-6383-4146-9971-34e92357c526.aspx
  
5004DirectAccesstoObstetrics/Gynecology(OB/GYN)ServicesMA00.032fAdministrative (00)MA00.032fMA00.0327393357c-6383-4146-9971-34e92357c526Direct Access to Obstetrics/Gynecology (OB/GYN) ServicesDirect Access to Obstetrics/Gynecology (OB/GYN) Services
{}
b603daf2-a4fa-4e28-a831-ae11942090f1.aspx
  
6016DirectEndoscopicNecrosectomy(DEN)fortheTreatmentofPancreaticNecrosisMA11.115Surgery (11)MA11.115MA11.115b603daf2-a4fa-4e28-a831-ae11942090f1Direct Endoscopic Necrosectomy (DEN) for the Treatment of Pancreatic NecrosisDirect Endoscopic Necrosectomy (DEN) for the Treatment of Pancreatic Necrosis
f1080c48-9401-4d71-8de9-6f864ed20ca8.aspx
  
6203Dofetilide(Tikosyn®)UseintheInpatientSettingMA08.021cPharmacy (08)MA08.021cMA08.021f1080c48-9401-4d71-8de9-6f864ed20ca8Dofetilide (Tikosyn®) Use in the Inpatient SettingDofetilide (Tikosyn®) Use in the Inpatient Setting
33c3e42b-4fa6-444d-ad2f-399988971cc5.aspx
  
5274Dostarlimab-gxly(Jemperli)MA08.136ePharmacy (08)MA08.136eMA08.13633c3e42b-4fa6-444d-ad2f-399988971cc5Dostarlimab-gxly (Jemperli)Dostarlimab-gxly (Jemperli)
1675f866-ac18-43ac-b4ea-b91b495be27a.aspx
  
5920Drug-ElutingBeadsandBlandEmbolizationfortheTreatmentofHepaticMalignanciesMA07.041cMedicine (07)MA07.041cMA07.0411675f866-ac18-43ac-b4ea-b91b495be27aDrug-Eluting Beads and Bland Embolization for the Treatment of Hepatic MalignanciesDrug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies
94cfd379-1b5e-4e75-a23b-097f9d0e3e60.aspx
  
6257DurableMedicalEquipment(DME)MA05.044tDME (05)MA05.044tMA05.04494cfd379-1b5e-4e75-a23b-097f9d0e3e60Durable Medical Equipment (DME)Durable Medical Equipment (DME)
{"6258": {"Id":6258,"MPAttachmentLetter":"B","Title":"Items that Do Not Meet the Definition of Durable Medical Equipment (DME) or Excluded from Coverage by Medicare","MPPolicyAttachmentInternalSourceId":9625,"PolicyAttachmentPageName":"8a665186-5f7e-4626-97b1-fd3b7a5effb6"},"6259": {"Id":6259,"MPAttachmentLetter":"A2","Title":"Equipment that Meets the Definition of Durable Medical Equipment (DME)","MPPolicyAttachmentInternalSourceId":9626,"PolicyAttachmentPageName":"8c34b224-c16d-4c4a-97c9-91678a020030"},"6260": {"Id":6260,"MPAttachmentLetter":"A1","Title":"Equipment that Meets the Definition of Durable Medical Equipment (DME)","MPPolicyAttachmentInternalSourceId":9627,"PolicyAttachmentPageName":"fd811c98-841f-4ef6-a181-86c2921ebfc4"},}
948db512-ee28-439f-85e5-fbbdbcdbebdd.aspx
  
5926DurableMedicalEquipment(DME)NotSubjecttoaRentaltoPurchaseMaximumMA05.028eDME (05)MA05.028eMA05.028948db512-ee28-439f-85e5-fbbdbcdbebddDurable Medical Equipment (DME) Not Subject to a Rental to Purchase MaximumDurable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum
a126f66b-dd30-4867-acc9-15c98ae07397.aspx
  
5476Durvalumab(Imfinzi®)andTremelimumab-actl(Imjudo®)MA08.123dPharmacy (08)MA08.123dMA08.123a126f66b-dd30-4867-acc9-15c98ae07397Durvalumab (Imfinzi®) and Tremelimumab-actl (Imjudo®)Durvalumab (Imfinzi®) and Tremelimumab-actl (Imjudo®)
{"5477": {"Id":5477,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":8515,"PolicyAttachmentPageName":"f71d838d-867f-4561-96df-b19b31ddb98e"},}
48ad8f5d-e94a-4bfd-88b8-84669e6b07cf.aspx
  
6248Eculizumab(Soliris®)andRelatedBiosimilars,Ravulizumab-cwvz(Ultomiris™)forintravenousadministrationMA08.044kPharmacy (08)MA08.044kMA08.04448ad8f5d-e94a-4bfd-88b8-84669e6b07cfEculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™) for intravenous  administrationEculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™) for intravenous administration
01d3741f-3291-4f05-8f2b-4ccdd5acabe9.aspx
  
5612Efbemalenograstimalfa-vuxw(Ryzneuta®),Eflapegrastim-xnst(Rolvedon™),Pegfilgrastim(Neulasta®)andRelatedBiosimilarsMA08.082mPharmacy (08)MA08.082mMA08.08201d3741f-3291-4f05-8f2b-4ccdd5acabe9Efbemalenograstim alfa-vuxw (Ryzneuta®), Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related BiosimilarsEfbemalenograstim alfa-vuxw (Ryzneuta®), Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related Biosimilars
{"5613": {"Id":5613,"MPAttachmentLetter":"A","Title":"EXAMPLES OF DISEASE SETTINGS AND CHEMOTHERAPY REGIMENS WITH A HIGH (>20%) OR INTERMEDIATE (10-20%) RISK FOR FEBRILE NEUTROPENIA","MPPolicyAttachmentInternalSourceId":8752,"PolicyAttachmentPageName":"0ce70873-f8f0-4798-a0a4-9a56f3d512b7"},}
3583e77f-7fea-4816-ab24-dae6b6f3bac9.aspx
  
5857Efgartigimodalfa-fcab(Vyvgart)andefgartigimodalfaandhyaluronidase-qvfc(VyvgartHytrulo)MA08.142dPharmacy (08)MA08.142dMA08.1423583e77f-7fea-4816-ab24-dae6b6f3bac9Efgartigimod alfa - fcab (Vyvgart) and efgartigimod alfa and hyaluronidase-qvfc (Vyvgart Hytrulo)Efgartigimod alfa - fcab (Vyvgart) and efgartigimod alfa and hyaluronidase-qvfc (Vyvgart Hytrulo)
c835851d-a3e1-4abb-b0c3-e8388227a0ac.aspx
  
5212ElectricalStimulationandElectromagneticStimulationfortheTreatmentofWoundsMA07.013dMedicine (07)MA07.013dMA07.013c835851d-a3e1-4abb-b0c3-e8388227a0acElectrical Stimulation and Electromagnetic Stimulation for the Treatment of WoundsElectrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds
{"5213": {"Id":5213,"MPAttachmentLetter":"A","Title":"ICD-10 Coding","MPPolicyAttachmentInternalSourceId":8448,"PolicyAttachmentPageName":"94938a3d-a163-4f16-94a9-e7458b8a1e15"},}
f40f516e-894f-483d-a388-c9945b9d765c.aspx
  
5441ElectroconvulsiveTherapy(ECT)MA14.001aBehavioral Health (14)MA14.001aMA14.001f40f516e-894f-483d-a388-c9945b9d765cElectroconvulsive Therapy (ECT)Electroconvulsive Therapy (ECT)
b889c657-8395-46af-8695-3141f205f441.aspx
  
5281Electromyography(EMG)Studies,NerveConductionStudies(NCS),andRelatedElectrodiagnosticStudiesMA07.050lMedicine (07)MA07.050lMA07.050b889c657-8395-46af-8695-3141f205f441Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic StudiesElectromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies
{"5282": {"Id":5282,"MPAttachmentLetter":"A","Title":"Recommended Guidelines for Electrodiagnostic Studies","MPPolicyAttachmentInternalSourceId":8120,"PolicyAttachmentPageName":"8243caa3-3a10-4498-9a14-41bd643d3dcf"},"5283": {"Id":5283,"MPAttachmentLetter":"D","Title":"ICD-10 Codes - Needle Electromyography for Guidance in Conjunction with Chemodenervation","MPPolicyAttachmentInternalSourceId":8436,"PolicyAttachmentPageName":"6c0ca294-4763-4698-a329-9269f379ed37"},"5284": {"Id":5284,"MPAttachmentLetter":"B","Title":"ICD10 Codes - Needle Electromyography and Nerve Conduction Studies","MPPolicyAttachmentInternalSourceId":8441,"PolicyAttachmentPageName":"e629c002-f21a-43c1-9548-1266bedd6ae7"},"5285": {"Id":5285,"MPAttachmentLetter":"C","Title":"ICD10 Codes - Electromyography of Anal or Urethral Sphincter","MPPolicyAttachmentInternalSourceId":8498,"PolicyAttachmentPageName":"63f6c25c-ec70-48c8-9fb8-4db29d7935c1"},"5286": {"Id":5286,"MPAttachmentLetter":"E","Title":"ICD10 Codes - Neuromuscular Junction Testing","MPPolicyAttachmentInternalSourceId":8499,"PolicyAttachmentPageName":"60da5bb5-97f7-4db9-904b-97cc97f8cb91"},"5287": {"Id":5287,"MPAttachmentLetter":"F","Title":"ICD10 Codes - Somatosensory Evoked Potentials (SSEPs)","MPPolicyAttachmentInternalSourceId":8502,"PolicyAttachmentPageName":"a8a36009-8594-41dc-9748-dfa336881de7"},}
6e0ef2cc-2603-4f7a-9bf1-f6e4c867a987.aspx
  
6327Elranatamab-bcmm(Elrexfio™)MA08.168Pharmacy (08)MA08.168MA08.1686e0ef2cc-2603-4f7a-9bf1-f6e4c867a987Elranatamab-bcmm (Elrexfio™)Elranatamab-bcmm (Elrexfio™)
1 - 100Next
Connect with Us

2025 Independence Blue Cross

Independence Blue Cross is a subsidiary of Independence Health Group, Inc. — independent licensees of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.