|  | | 523 | AlwaysBundledProcedureCodesMA00.026u | Administrative (00) | MA00.026u | MA00.026 | e4d529b4-77b4-4fc2-afb3-83c90ffaace3 | Always Bundled Procedure Codes | Always Bundled Procedure Codes | {"524": {"Id":524,"MPAttachmentLetter":"B","Title":"Procedures/Services Not Eligible for Separate Reimbursement","MPPolicyAttachmentInternalSourceId":8885,"PolicyAttachmentPageName":"bbac3ebb-06ee-48ed-89d6-72b078185a48"},"525": {"Id":525,"MPAttachmentLetter":"C","Title":"Procedures/Services Not Eligible for Reimbursement","MPPolicyAttachmentInternalSourceId":8886,"PolicyAttachmentPageName":"dbf8fdc1-ded5-43af-a92b-adf49176e77a"},"526": {"Id":526,"MPAttachmentLetter":"A","Title":"Always Bundled Procedures (MPFSD Indicator B)","MPPolicyAttachmentInternalSourceId":8887,"PolicyAttachmentPageName":"f32553d0-3e83-43f5-9a83-d533fd30d5f3"},} |
| | | 387 | BillingforProfessionalOffice-BasedServicesPerformedinanOutpatientOffice-BasedSettingLocatedwithinaFacilityoronaFacilityCampusMA00.037l | Administrative (00) | MA00.037l | MA00.037 | a98a0a5b-faee-4011-916e-6b7e0b0cb2e7 | Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus | Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus | {"388": {"Id":388,"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":7909,"PolicyAttachmentPageName":"da46264d-710a-4d99-bac3-2e5524ea2b5c"},} |
| | | 437 | CareManagementandCarePlanningServicesMA00.006n | Administrative (00) | MA00.006n | MA00.006 | eeea6e1f-8b21-4c3b-9764-923b708182fa | Care Management and Care Planning Services | Care Management and Care Planning Services | |
| | | 535 | CastandSplintApplicationsandAssociatedSuppliesMA00.012c | Administrative (00) | MA00.012c | MA00.012 | 9c2590d7-e073-4b5d-9602-400cccc67903 | Cast and Splint Applications and Associated Supplies | Cast and Splint Applications and Associated Supplies | {"536": {"Id":536,"MPAttachmentLetter":"A","Title":"Procedures Related to Cast and Splint Applications and Associated Supplies","MPPolicyAttachmentInternalSourceId":8998,"PolicyAttachmentPageName":"591c8fb9-e9a1-41f0-9870-b3a9a64ecaf8"},} |
| | | 493 | ComplementaryandIntegrativeHealthServicesMA12.001e | Miscellaneous (12) | MA12.001e | MA12.001 | 64558b3d-820c-4bf9-89f4-aa6f5971cfab | Complementary and Integrative Health Services | Complementary and Integrative Health Services | |
| | | 206 | ConsultationServicesMA00.049a | Administrative (00) | MA00.049a | MA00.049 | 57649d5c-49aa-4216-9686-3c820b5d1237 | Consultation Services | Consultation Services | |
| | | 237 | ContrastAgentsUsedinConjunctionwithEchocardiographyMA09.004c | Radiology (09) | MA09.004c | MA09.004 | 16379ab5-1c4e-4ad3-9aa8-49dea5cd3d30 | Contrast Agents Used in Conjunction with Echocardiography | Contrast Agents Used in Conjunction with Echocardiography | |
| | | 38 | Criteria for Reimbursement of Emergency Room Services | Administrative (00) | MA00.044b | MA00.044 | 85257D39006E7945852584FD00658A7A | Criteria for Reimbursement of Emergency Room Services | Criteria for Reimbursement of Emergency Room Services | |
| | | 389 | DirectAccesstoObstetrics/Gynecology(OB/GYN)ServicesMA00.032f | Administrative (00) | MA00.032f | MA00.032 | 5ee3343f-4d11-4033-86cc-6bc84fb21ce4 | Direct Access to Obstetrics/Gynecology (OB/GYN) Services | Direct Access to Obstetrics/Gynecology (OB/GYN) Services | {} |
| | | 489 | DurableMedicalEquipment(DME)MA05.044q | DME (05) | MA05.044q | MA05.044 | 3d23f9f2-f4a8-45f3-944c-f728beaff748 | Durable Medical Equipment (DME) | Durable Medical Equipment (DME) | {"490": {"Id":490,"MPAttachmentLetter":"B","Title":"Items that Do Not Meet the Definition of Durable Medical Equipment (DME) or Excluded from Coverage by Medicare","MPPolicyAttachmentInternalSourceId":8660,"PolicyAttachmentPageName":"539a9b86-2034-4387-ba82-ed9f5486e870"},"491": {"Id":491,"MPAttachmentLetter":"A2","Title":"Equipment that Meets the Definition of Durable Medical Equipment (DME)","MPPolicyAttachmentInternalSourceId":8661,"PolicyAttachmentPageName":"0e00e243-9fe0-42b4-8fab-2b2791f477cc"},"492": {"Id":492,"MPAttachmentLetter":"A1","Title":"Equipment that Meets the Definition of Durable Medical Equipment (DME)","MPPolicyAttachmentInternalSourceId":8662,"PolicyAttachmentPageName":"2fc7bde8-f874-4079-a969-6741959816ae"},} |
| | | 238 | DurableMedicalEquipment(DME)NotSubjecttoaRentaltoPurchaseMaximumMA05.028e | DME (05) | MA05.028e | MA05.028 | 81644841-0f55-4dc1-9476-5ab8d631fd3a | Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum | Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum | |
| | | 533 | FacilityReportingofObservationServicesMA00.040b | Administrative (00) | MA00.040b | MA00.040 | 7baa5f1c-27fa-4aa0-a7d0-62d6e2937813 | Facility Reporting of Observation Services | Facility Reporting of Observation Services | |
| | | 494 | HighOsmolarContrastAgentsMA09.005a | Radiology (09) | MA09.005a | MA09.005 | 2b7d06bc-67ae-423a-8f21-ba39734c69be | High Osmolar Contrast Agents | High Osmolar Contrast Agents | |
| | | 534 | InpatientHospitalReadmissionMA00.023b | Administrative (00) | MA00.023b | MA00.023 | a88e0a82-43b4-44d6-b004-adde57888155 | Inpatient Hospital Readmission | Inpatient Hospital Readmission | |
| | | 316 | Instrument-BasedVisionScreeningMA07.048a | Medicine (07) | MA07.048a | MA07.048 | c9388493-27eb-4cf4-bf9f-6916792f003e | Instrument-Based Vision Screening | Instrument-Based Vision Screening | |
| | | 26 | Intravenous (IV) Administration of Fluids as a Treatment of a Medical Condition or for the Preparation of Pharmaceuticals, Biologics, and other Substances | Administrative (00) | MA00.022 | MA00.022 | 85257D39006E79458525847100593A59 | Intravenous (IV) Administration of Fluids as a Treatment of a Medical Condition or for the Preparation of Pharmaceuticals, Biologics, and other Substances | Intravenous (IV) Administration of Fluids as a Treatment of a Medical Condition or for the Preparation of Pharmaceuticals, Biologics, and other Substances | |
| | | 320 | LowOsmolarContrastAgentsMA09.008a | Radiology (09) | MA09.008a | MA09.008 | 1f017774-27b5-4e40-b888-b50219a82b0b | Low Osmolar Contrast Agents | Low Osmolar Contrast Agents | |
| | | 383 | MagneticResonanceImaging(MRI)ContrastAgentsMA09.010e | Radiology (09) | MA09.010e | MA09.010 | b3e6d4bd-3857-482f-b8fe-382d2592a05e | Magnetic Resonance Imaging (MRI) Contrast Agents | Magnetic Resonance Imaging (MRI) Contrast Agents | |
| | | 233 | Modifier24:UnrelatedEvaluationandManagementServicebytheSamePhysicianorOtherQualifiedHealthCareProfessionalDuringaPostoperativePeriodMA03.009e | Clinical Logic (03) | MA03.009e | MA03.009 | 7c7a87e2-ec6e-4784-b62c-646710563f53 | Modifier 24: Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period | Modifier 24: Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period | |
| | | 423 | Modifier25:Significant,SeparatelyIdentifiableEvaluationandManagementServicebytheSamePhysicianorOtherQualifiedHealthCareProfessionalontheSameDayoftheProcedureorOtherServiceMA03.003n | Clinical Logic (03) | MA03.003n | MA03.003 | 1506ee5d-44dd-4734-9976-5bfa8af5402a | Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service | Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service | {"424": {"Id":424,"MPAttachmentLetter":"B","Title":"Problem-focused E&M codes appended with modifier 25 should be reimbursed at 50 percent of the applicable fee schedule amount when submitted on the same date of service, by the same professional provider or other qualified health care provider, as a preven","MPPolicyAttachmentInternalSourceId":8367,"PolicyAttachmentPageName":"45186410-2e73-4858-a1a5-54156434bcbf"},"425": {"Id":425,"MPAttachmentLetter":"A","Title":"E&M codes appended with modifier 25 should be reimbursed at 50 percent of the applicable fee schedule amount when submitted on the same date of service, by the same professional provider or other qualified health care provider, as a minor procedure.","MPPolicyAttachmentInternalSourceId":8368,"PolicyAttachmentPageName":"5c56c7e5-0ecc-4b01-92c3-ce83e58a05a9"},} |
| | | 528 | Modifier50:BilateralProcedureMA03.002r | Clinical Logic (03) | MA03.002r | MA03.002 | 3c183b2f-c4b1-4898-ba39-7e80505c753f | Modifier 50: Bilateral Procedure | Modifier 50: Bilateral Procedure | |
| | | 226 | Modifier52:ReducedServicesMA03.014b | Clinical Logic (03) | MA03.014b | MA03.014 | b3b91395-a317-41de-b416-eb880d28e0c9 | Modifier 52: Reduced Services | Modifier 52: Reduced Services | |
| | | 225 | Modifier53:DiscontinuedProcedureMA03.018b | Clinical Logic (03) | MA03.018b | MA03.018 | 78b314b5-371e-497f-a26b-8462a03d2d6b | Modifier 53: Discontinued Procedure | Modifier 53: Discontinued Procedure | |
| | | 235 | Modifier57:DecisionforSurgeryMA03.010e | Clinical Logic (03) | MA03.010e | MA03.010 | 3967153e-3d87-4efc-bdab-40f3a1f59027 | Modifier 57: Decision for Surgery | Modifier 57: Decision for Surgery | |
| | | 529 | Modifier62:TwoSurgeonsMA00.011s | Administrative (00) | MA00.011s | MA00.011 | 0110bd94-aea0-445f-9f61-2d16aa53ec53 | Modifier 62: Two Surgeons | Modifier 62: Two Surgeons | |
| | | 342 | Modifier66:SurgicalTeam00.10.17n | Administrative (00) | 00.10.17n | 00.10.17 | 8075c0eb-cae3-4198-8235-c37ffc1458ec | Modifier 66: Surgical Team | Modifier 66: Surgical Team | {"343": {"Id":343,"MPAttachmentLetter":"A","Title":"Team Surgery Review Form","MPPolicyAttachmentInternalSourceId":7496,"PolicyAttachmentPageName":"ad8dc974-bba0-4e07-a7f0-22e373cfbb59"},} |
| | | 419 | Modifier66:SurgicalTeamMA00.014j | Administrative (00) | MA00.014j | MA00.014 | e9bc950d-7cc1-41e1-9170-192df7aa0a5d | Modifier 66: Surgical Team | Modifier 66: Surgical Team | {"420": {"Id":420,"MPAttachmentLetter":"A","Title":"Team Surgery Review Form","MPPolicyAttachmentInternalSourceId":8360,"PolicyAttachmentPageName":"0b4d0877-ecdb-4972-9739-96fa96bd6104"},} |
| | | 322 | Modifier76:RepeatProcedureorServicebySamePhysicianorOtherQualifiedHealthCareProfessionalMA03.001b | Clinical Logic (03) | MA03.001b | MA03.001 | 108de71a-6f89-49a0-b5ca-4e6efc35f5b7 | Modifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional | Modifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional | |
| | | 234 | Modifier77:RepeatProcedureorServicebyAnotherPhysicianorOtherQualifiedHealthCareProfessionalMA03.007b | Clinical Logic (03) | MA03.007b | MA03.007 | 3d544cfc-22c9-4703-a5fb-49be357d1621 | Modifier 77: Repeat Procedure or Service by Another Physician or Other Qualified Health Care Professional | Modifier 77: Repeat Procedure or Service by Another Physician or Other Qualified Health Care Professional | |
| | | 229 | Modifier78:UnplannedReturntotheOperating/ProcedureRoombytheSamePhysicianorOtherQualifiedHealthCareProfessionalFollowingInitialProcedureforaRelatedProcedureDuringthePostoperativePeriodMA03.008c | Clinical Logic (03) | MA03.008c | MA03.008 | 871b932b-3206-4e2c-b15e-732c7fc05552 | Modifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period | Modifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period | |
| | | 228 | Modifier79:UnrelatedProcedureorServicebytheSamePhysicianorOtherQualifiedHealthCareProfessionalDuringthePostoperativePeriodMA03.012d | Clinical Logic (03) | MA03.012d | MA03.012 | 4e608449-a0f5-4080-b758-a286fd5284a2 | Modifier 79: Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period | Modifier 79: Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period | |
| | | 538 | Modifiers26(ProfessionalComponent)andTC(TechnicalComponent)MA03.011n | Clinical Logic (03) | MA03.011n | MA03.011 | 6ad04bef-138e-4695-a223-11b214bf7a9c | Modifiers 26 (Professional Component) and TC (Technical Component) | Modifiers 26 (Professional Component) and TC (Technical Component) | |
| | | 530 | ModifiersforAssistant-at-SurgeryServices:80,81,82,andASMA00.015q | Administrative (00) | MA00.015q | MA00.015 | 8062696c-da48-49cf-8a6d-f8378f59ea88 | Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS | Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS | |
| | | 227 | ModifiersforSharedorSplitSurgicalServices(Modifiers54,55,56)MA03.017c | Clinical Logic (03) | MA03.017c | MA03.017 | 754fd78f-3dcb-4ec4-95b9-c03173e9e155 | Modifiers for Shared or Split Surgical Services (Modifiers 54, 55, 56) | Modifiers for Shared or Split Surgical Services (Modifiers 54, 55, 56) | |
| | | 537 | ModifiersXE,XS,XP,XU,and59MA03.005c | Clinical Logic (03) | MA03.005c | MA03.005 | 62fb0352-3f73-451e-8478-f4898a64c9de | Modifiers XE, XS, XP, XU, and 59 | Modifiers XE, XS, XP, XU, and 59 | |
| | | 216 | MultipleProcedurePaymentReduction(MPPR)onCertainDiagnosticServicesMA01.005g | Anesthesia (01) | MA01.005g | MA01.005 | fd9441f7-3279-41e1-bde4-0636c6810afa | Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services | Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services | {"3363": {"Id":3363,"MPAttachmentLetter":"A","Title":"Multiple Reduction Diagnostic Services","MPPolicyAttachmentInternalSourceId":6183,"PolicyAttachmentPageName":"3d828328-07f3-4691-bef2-636e924f8f5d"},} |
| | | 438 | MultipleProcedurePaymentReductionGuidelinesforPhysical,Occupational,andSpeechTherapyServicesMA00.050a | Administrative (00) | MA00.050a | MA00.050 | 57615dab-e0d9-4064-ad0c-db02855b6b96 | Multiple Procedure Payment Reduction Guidelines for Physical, Occupational, and Speech Therapy Services | Multiple Procedure Payment Reduction Guidelines for Physical, Occupational, and Speech Therapy Services | {"439": {"Id":439,"MPAttachmentLetter":"A","Title":"Multiple Reduction Always Therapy Procedure Codes","MPPolicyAttachmentInternalSourceId":8422,"PolicyAttachmentPageName":"0b0bff4f-045e-492d-be7c-417025aa60c9"},} |
| | | 242 | MultipleSurgeryPaymentReductionMA11.032g | Surgery (11) | MA11.032g | MA11.032 | 14e44a56-51b8-43c2-b8d5-44832b823eb7 | Multiple Surgery Payment Reduction | Multiple Surgery Payment Reduction | {"2365": {"Id":2365,"MPAttachmentLetter":"B","Title":"Healthcare Common Procedure Coding System (HCPCS) Codes To Which Multiple Surgery Payment Reduction Applies","MPPolicyAttachmentInternalSourceId":5200,"PolicyAttachmentPageName":"5487ae51-4894-4e7b-bc51-57df334037a3"},"2366": {"Id":2366,"MPAttachmentLetter":"A1","Title":"Current Procedural Terminology (CPT) Codes To Which Multiple Surgery Payment Reduction Applies","MPPolicyAttachmentInternalSourceId":5201,"PolicyAttachmentPageName":"a29a89c1-f55f-4ed1-bc3c-d6b6cec65485"},"2367": {"Id":2367,"MPAttachmentLetter":"A2","Title":"Current Procedural Terminology (CPT) Codes To Which Multiple Surgery Payment Reduction Applies","MPPolicyAttachmentInternalSourceId":5202,"PolicyAttachmentPageName":"2da26839-2a31-4c3c-8740-de28290c0326"},} |
| | | 223 | NationalCorrectCodingInitiative(NCCI)CodePairEditsMA00.041a | Administrative (00) | MA00.041a | MA00.041 | 53e83cf3-3d26-4d7c-b6e9-e65fe70e798e | National Correct Coding Initiative (NCCI) Code Pair Edits | National Correct Coding Initiative (NCCI) Code Pair Edits | |
| | | 531 | OctreotideAcetate(Sandostatin®LARDepot)MA08.065i | Pharmacy (08) | MA08.065i | MA08.065 | 625a8546-38bb-41dd-840a-931b6873bf9f | Octreotide Acetate (Sandostatin® LAR Depot) | Octreotide Acetate (Sandostatin® LAR Depot) | {"532": {"Id":532,"MPAttachmentLetter":"A","Title":"ICD-10 codes and narratives","MPPolicyAttachmentInternalSourceId":8829,"PolicyAttachmentPageName":"f5d5581c-887d-4c50-b6ff-650297953731"},} |
| | | 501 | PPONetworkRulesforProvisionofSpecialtyServicesforDurableMedicalEquipmentandLaboratory,Radiology,andPhysicalMedicineandRehabilitativeServices00.01.25bo | Administrative (00) | 00.01.25bo | 00.01.25 | 0bad1bd7-e1f2-4563-a905-28a6b759ec5c | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | {"502": {"Id":502,"MPAttachmentLetter":"A3","Title":"DME Network Rules and Limited Circumstances","MPPolicyAttachmentInternalSourceId":8775,"PolicyAttachmentPageName":"a46126c7-f80e-4547-9006-c7ee01d5871f"},"503": {"Id":503,"MPAttachmentLetter":"B1","Title":"Laboratory Network Rules and Limited Circumstances","MPPolicyAttachmentInternalSourceId":8776,"PolicyAttachmentPageName":"2b6caa60-97bb-441b-8a47-465ac3fe95d1"},"504": {"Id":504,"MPAttachmentLetter":"D","Title":"Physical Medicine & Rehabilitation Network Rules and Limited Circumstances","MPPolicyAttachmentInternalSourceId":8777,"PolicyAttachmentPageName":"f876baf0-1b07-4c49-a775-97e7594c732f"},"505": {"Id":505,"MPAttachmentLetter":"B3","Title":"Laboratory Network Rules and Limited Circumstances cont'd.","MPPolicyAttachmentInternalSourceId":8778,"PolicyAttachmentPageName":"3e8993d2-ea1c-475b-a2e0-cbe9fca293f8"},"506": {"Id":506,"MPAttachmentLetter":"C2","Title":"Radiology Network Rules and Limited Circumstances cont'd.","MPPolicyAttachmentInternalSourceId":8779,"PolicyAttachmentPageName":"52250a28-b82a-4cb2-a9a9-b71de051fc0b"},"507": {"Id":507,"MPAttachmentLetter":"C1","Title":"Radiology Network Rules and Limited Circumstances","MPPolicyAttachmentInternalSourceId":8780,"PolicyAttachmentPageName":"e37db876-063e-4620-8f28-526e96ea0d13"},"508": {"Id":508,"MPAttachmentLetter":"B2.2","Title":"Laboratory Network Rules and Limited Circumstances cont'd.","MPPolicyAttachmentInternalSourceId":8781,"PolicyAttachmentPageName":"7f3d0ca3-3825-4920-9b82-481c1149f534"},"509": {"Id":509,"MPAttachmentLetter":"A1","Title":"DME Network Rules and Limited Circumstances","MPPolicyAttachmentInternalSourceId":8782,"PolicyAttachmentPageName":"63ff3d84-a760-49c4-8793-91a998a7a1d8"},"510": {"Id":510,"MPAttachmentLetter":"A2","Title":"DME Network Rules and Limited Circumstances cont'd.","MPPolicyAttachmentInternalSourceId":8783,"PolicyAttachmentPageName":"b72bee7b-5b22-4438-ab50-9769ff5272ea"},"511": {"Id":511,"MPAttachmentLetter":"B2.1","Title":"Laboratory Network Rules and Limited Circumstances cont'd.","MPPolicyAttachmentInternalSourceId":8784,"PolicyAttachmentPageName":"08872f55-7e7e-435a-baae-7fda9691f5a5"},} |
| | | 512 | PPONetworkRulesforProvisionofSpecialtyServicesforDurableMedicalEquipmentandLaboratory,Radiology,andPhysicalMedicineandRehabilitativeServicesMA00.010ap | Administrative (00) | MA00.010ap | MA00.010 | b82424b8-9353-4590-be12-e27f7b5f593e | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | {"513": {"Id":513,"MPAttachmentLetter":"B1","Title":"Laboratory Network Rules and Limited Circumstances","MPPolicyAttachmentInternalSourceId":8798,"PolicyAttachmentPageName":"b1eb58f6-dfe1-4170-be25-52c2022e37e1"},"514": {"Id":514,"MPAttachmentLetter":"A3","Title":"DME Network Rules and Limited Circumstances","MPPolicyAttachmentInternalSourceId":8799,"PolicyAttachmentPageName":"dca64698-8697-42a6-954f-581bafcb00df"},"515": {"Id":515,"MPAttachmentLetter":"D","Title":"Physical Medicine & Rehabilitation Network Rules and Limited Circumstances","MPPolicyAttachmentInternalSourceId":8800,"PolicyAttachmentPageName":"2235f973-2946-4a0d-9dd7-050d09f4b6ae"},"516": {"Id":516,"MPAttachmentLetter":"B3","Title":"Laboratory Network Rules and Limited Circumstances cont'd.","MPPolicyAttachmentInternalSourceId":8801,"PolicyAttachmentPageName":"67447604-8cf2-484e-836e-89b45edb9778"},"517": {"Id":517,"MPAttachmentLetter":"C2","Title":"Radiology Network Rules and Limited Circumstances cont'd.","MPPolicyAttachmentInternalSourceId":8802,"PolicyAttachmentPageName":"3b553872-1af4-47c2-8a45-267a1dc8b851"},"518": {"Id":518,"MPAttachmentLetter":"C1","Title":"Radiology Network Rules and Limited Circumstances","MPPolicyAttachmentInternalSourceId":8803,"PolicyAttachmentPageName":"fa20f181-48c4-4d33-915c-e022941a89a5"},"519": {"Id":519,"MPAttachmentLetter":"B2.2","Title":"Laboratory Network Rules and Limited Circumstances cont'd.","MPPolicyAttachmentInternalSourceId":8804,"PolicyAttachmentPageName":"13385570-318c-4180-8342-7d67fffdd50c"},"520": {"Id":520,"MPAttachmentLetter":"A1","Title":"DME Network Rules and Limited Circumstances","MPPolicyAttachmentInternalSourceId":8805,"PolicyAttachmentPageName":"61916667-cd36-424d-8591-6d80823c6b5a"},"521": {"Id":521,"MPAttachmentLetter":"A2","Title":"DME Network Rules and Limited Circumstances cont'd.","MPPolicyAttachmentInternalSourceId":8806,"PolicyAttachmentPageName":"cde7b111-0fa7-4a66-90b7-ed644f66d773"},"522": {"Id":522,"MPAttachmentLetter":"B2.1","Title":"Laboratory Network Rules and Limited Circumstances","MPPolicyAttachmentInternalSourceId":8807,"PolicyAttachmentPageName":"1f72a56b-1a5b-457b-8db2-ce5cec11465a"},} |
| | | 498 | RadiologicGuidanceand/orSupervisionandInterpretationofaProcedureMA00.019j | Administrative (00) | MA00.019j | MA00.019 | c552c0ac-61f2-41e7-b6d1-8c4e3aa2881f | Radiologic Guidance and/or Supervision and Interpretation of a Procedure | Radiologic Guidance and/or Supervision and Interpretation of a Procedure | {"499": {"Id":499,"MPAttachmentLetter":"A","Title":"Radiologic Guidance and Supervision and Interpretation Procedure Codes","MPPolicyAttachmentInternalSourceId":8796,"PolicyAttachmentPageName":"61155915-a13f-431b-8077-6377357d6ec8"},} |
| | | 500 | ReimbursementforanIntraocularLensMA11.043a | Surgery (11) | MA11.043a | MA11.043 | d609a3cb-2796-433d-a328-73ebb0a83049 | Reimbursement for an Intraocular Lens | Reimbursement for an Intraocular Lens | |
| | | 317 | ReimbursementforComponentsofComprehensiveLaboratoryPanelsMA01.006a | Anesthesia (01) | MA01.006a | MA01.006 | 27dfc768-a6c5-4bb2-bcad-af6af286f7d0 | Reimbursement for Components of Comprehensive Laboratory Panels | Reimbursement for Components of Comprehensive Laboratory Panels | {"3501": {"Id":3501,"MPAttachmentLetter":"A","Title":"CPT Codes","MPPolicyAttachmentInternalSourceId":6269,"PolicyAttachmentPageName":"c3e1e19e-e85e-4bd8-8539-4253851dd46a"},} |
| | | 426 | ReimbursementforRadiopharmaceuticalAgentsforProfessionalProvidersMA09.009t | Radiology (09) | MA09.009t | MA09.009 | e878519c-21b5-4bee-9983-93c313716bbc | Reimbursement for Radiopharmaceutical Agents for Professional Providers | Reimbursement for Radiopharmaceutical Agents for Professional Providers | |
| | | 245 | ReimbursementfortheAdministrationofImmunizationsMA07.019b | Medicine (07) | MA07.019b | MA07.019 | 1e93764f-529e-41b2-9a1d-90e82cfe5933 | Reimbursement for the Administration of Immunizations | Reimbursement for the Administration of Immunizations | |
| | | 427 | RepairandReplacementofDurableMedicalEquipment(DME)andProstheticDevicesMA05.062j | DME (05) | MA05.062j | MA05.062 | 1db75e7b-824a-4841-bcbb-1762ea2edd6f | Repair and Replacement of Durable Medical Equipment (DME) and Prosthetic Devices | Repair and Replacement of Durable Medical Equipment (DME) and Prosthetic Devices | {"428": {"Id":428,"MPAttachmentLetter":"A","Title":"A list of Healthcare Common Procedure Coding System (HCPCS) codes with narratives that are specific to repair or replacement","MPPolicyAttachmentInternalSourceId":8373,"PolicyAttachmentPageName":"edd7a6c1-4be0-4fe1-989b-6e5f1a6aec4b"},} |
| | | 385 | ReportingandDocumentationRequirementsforAnesthesiaServicesMA00.009h | Administrative (00) | MA00.009h | MA00.009 | fdae72fc-2278-473c-bee5-78d7a931a048 | Reporting and Documentation Requirements for Anesthesia Services | Reporting and Documentation Requirements for Anesthesia Services | {"386": {"Id":386,"MPAttachmentLetter":"A","Title":"ASA Anesthesia Procedure Codes","MPPolicyAttachmentInternalSourceId":7906,"PolicyAttachmentPageName":"916c89e8-5615-43f9-ae62-0b94c2d45873"},} |
| | | 244 | ReportingRequirementsforDrugsandBiologicsMA00.024c | Administrative (00) | MA00.024c | MA00.024 | 6a8a5b51-0ab2-401d-854b-796e864abb3a | Reporting Requirements for Drugs and Biologics | Reporting Requirements for Drugs and Biologics | |
| | | 413 | Rituximab(Rituxan®)InfusionandRelatedBiosimilars,andRituximab/HyaluronidaseHumanforSubcutaneousInjection(RituxanHycela®)08.00.50ac | Pharmacy (08) | 08.00.50ac | 08.00.50 | def96ce9-b2ef-446a-bfc7-ae6c511328cd | Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®) | Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®) | {"414": {"Id":414,"MPAttachmentLetter":"A","Title":"ICD-10 CODES AND NARRATIVES","MPPolicyAttachmentInternalSourceId":7615,"PolicyAttachmentPageName":"7597e00c-c644-4c2a-a9ee-9a8a6e290a88"},} |
| | | 415 | Rituximab(Rituxan®)InfusionandRelatedBiosimilars,andRituximab/HyaluronidaseHumanforSubcutaneousInjection(RituxanHycela®)MA08.022q | Pharmacy (08) | MA08.022q | MA08.022 | fcb293a4-1191-49f7-b6da-7af428d9e34d | Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®) | Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®) | {"416": {"Id":416,"MPAttachmentLetter":"A","Title":"ICD-10 CODES AND NARRATIVES","MPPolicyAttachmentInternalSourceId":7675,"PolicyAttachmentPageName":"5371dde7-b34d-47de-bde4-93b6d2c1744e"},} |
| | | 369 | ServicesPaidAboveCapitationforHealthMaintenanceOrganization(HMO)andHealthMaintenanceOrganizationPoint-of-Service(HMO-POS)PrimaryCareProvidersMA00.033o | Administrative (00) | MA00.033o | MA00.033 | 2d997ee4-fb5b-4de2-9ca2-63b77e6988d7 | Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers | Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers | {"370": {"Id":370,"MPAttachmentLetter":"A: PENNSYLVANIA","Title":"Pennsylvania Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers","MPPolicyAttachmentInternalSourceId":7874,"PolicyAttachmentPageName":"71802772-d6ed-4561-b6b4-7ff2388dd4fc"},"371": {"Id":371,"MPAttachmentLetter":"B: NEW JERSEY","Title":"New Jersey Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers","MPPolicyAttachmentInternalSourceId":7875,"PolicyAttachmentPageName":"b3c9d5f8-74b1-4405-9729-2840a8708e26"},} |
| | | 323 | UseofaRobotic-AssistedSurgicalSystemMA11.057b | Surgery (11) | MA11.057b | MA11.057 | 0cdfcd0f-4f8f-4c85-abd8-0cfd327fe080 | Use of a Robotic-Assisted Surgical System | Use of a Robotic-Assisted Surgical System | |
| | | 495 | X-raysAssociatedwithFracturesintheOfficeSettingMA00.031f | Administrative (00) | MA00.031f | MA00.031 | b7105d98-bb14-4beb-9a2a-663877687c13 | X-rays Associated with Fractures in the Office Setting | X-rays Associated with Fractures in the Office Setting | {"496": {"Id":496,"MPAttachmentLetter":"B","Title":"Codes eligible for reimbursement when billed by Podiatrists","MPPolicyAttachmentInternalSourceId":8845,"PolicyAttachmentPageName":"7417b786-3ee4-46b4-b4e6-63d80233f544"},"497": {"Id":497,"MPAttachmentLetter":"A","Title":"Codes eligible for reimbursement when billed by Hand Surgeons, Orthopedic Surgeons, Sports Medicine, Pediatric Sports Medicine, or Orthopedic Sports Medicine Specialists","MPPolicyAttachmentInternalSourceId":8847,"PolicyAttachmentPageName":"d916243d-a23e-4cf9-8f1f-29c73100fd00"},} |
