| After Hours and Weekend Care |
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| Allergy Testing Immunotherapy |
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| Ambulatory Surgical Groupers |
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| Anesthesia Reimbursement Policy |
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| Assistant at Surgery – Modifiers 80/81/82 and AS (Commercial) |
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| Billing for Habilitative and Rehabilitative Services |
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| Biomarkers Testing for Autoimmune Rheumatic Disease (LBM) |
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| Bundled Services (Commercial and Medicare) |
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| Coding Edits Policy (Commercial, Medicare, and Medicaid) |
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| Colorectal Cancer (LBM) |
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| Compression Garments |
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| Computer Assisted Surgical Navigation |
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| Coronavirus Testing in the Outpatient Setting (LBM) |
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| Corrected Claim Submission |
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| Co-Surgeon/Team Surgeon-Modifiers 62/66 |
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| CPT and HCPCS Billing Guidelines |
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| Daily Maximum Units (Commercial/Medicare) |
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| Diagnosis Code Guidelines: Manifestation/Secondary Diagnosis Codes |
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| Discarded Drugs/Biologicals – Modifiers JW and JZ (Commercial) |
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| Discontinued Procedures – Modifiers 53, 73 & 74 (Commercial) |
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| DME In-Office/Non-Facility |
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| DME Rental vs. Purchase |
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| Drug Alcohol Testing (Commercial/Medicaid) |
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| Drugs and Biologicals |
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| Emergency Department Facility E&M Coding’ |
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| Evaluation and Management (E&M) Services |
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| Facility Fees for E&M Services on Outpatient Facility Claims |
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| From/To Date Span |
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| Hepatitis Testing (LBM) |
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| Home Health Care Services |
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| Hospital Readmissions |
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| Human Immunodeficiency Virus (HIV) (LBM) |
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| Intraoperative Neurophysiology Monitoring Services (IONM) |
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| Laboratory/Venipuncture |
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| Laboratory/Venipuncture - Effective 1/1/2025 |
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| Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Tremor |
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| Mid-Level Practitioner Reimbursement Policy (Commercial) |
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| Modifier SU – Procedure Performed in Physician’s Office (Commercial) |
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| Modifier Reference Policy |
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| Modifiers PN & PO for Clinic Visit Services (G0463) – (Medicare) |
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| Multiple & Bilateral Surgical Procedures Policy |
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| Multiple Diagnostic Imaging Payment Reduction Policy (Commercial) |
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| Multiple Procedure Reduction Cardiology/Ophthalmology |
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| National Drug Code (NDC) Requirements for Drug Claims – Commercial, Medicare, and Medicaid |
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| Never Events/Adverse Events & Serious Reportable Events (Commercial) |
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| No Cost/Reduced Cost Drugs, Implants & Devices |
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| Observation Stay - Commercial |
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| Observation Stay – Medicare and Medicaid |
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| Operating Microscope/Microsurgery (CPT 64727/69990) |
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| Ophthalmology Reimbursement Policy |
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| Outpatient Diagnostic Imaging Self-Referral Payment Policy |
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| Preventive Care Services (Commercial and Medicaid) |
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| Preventive Care Services (Medicare) |
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| Preventive Medicine and Screening (Commercial) |
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| Prolonged Services (Commercial, Medicare and Medicaid) |
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| Radiology Cardiology Ultrasound Bundling Rules (Administered by EviCore) |
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| Radiology Cardiology Ultrasound Frequency Rules (Administered by EviCore) |
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| Radiology Cardiology Ultrasound Correct Coding Rules (Administered by EviCore) |
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| Radiopharmaceuticals and Contrast Media |
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| Revenue Codes Requiring Detailed Coding |
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| Robotic Surgery |
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| Routine Foot Care Services |
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| Specialty Pharmacy Requirements Drug List |
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| Split Surgical Care (Modifiers 54/55/56) (Commercial) |
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| Telehealth/Virtual Care Services |
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| Therapeutic Drug Monitoring of 5-Fluorouracil (LBM) |
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| Treatment Room |
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| Unlisted Codes |
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| B-Hemolytic Streptococcus Testing (LBM) |
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| Biochemical Markers of Alzheimer Disease and Dementia (LBM) |
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| Bone Turnover Markers Testing (LBM) |
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| Celiac Disease Testing (LBM) |
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| Cervical Cancer Screening (LBM) |
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| Diagnosis of Vaginitis (LBM) |
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| Diagnostic Testing of Common Sexually Transmitted Infections (LBM) |
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| Diagnostic Testing of Influenza (LBM) |
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| Epithelial Cell Cytology in Breast Cancer Risk Assessment (LBM) |
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| Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing (LBM) |
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| Fecal Calprotectin Testing in Adults (LBM) |
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| Flow Cytometry (LBM) |
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| Folate Testing (LBM) |
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| Gamma-Glutamyl Transferase (LBM) |
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| General Inflammation Testing (LBM) |
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| Helicobacter Pylori Testing (LBM) |
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| Immunohistochemistry (LBM) |
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| Immunopharmacologic Monitoring of Therapeutic Serum Antibodies (LBM) |
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| In Vitro Chemoresistance and Chemosensitivity Assays (LBM) |
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| Lyme Disease Testing (LBM) |
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| Measurement of Thromboxane Metabolites for ASA Resistance (LBM) |
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| Nerve Fiber Density Testing (LBM) |
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| Onychomycosis Testing (LBM) |
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| Oral Cancer Screening and Testing (LBM) |
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| Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing (LBM) |
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| Pediatric Preventive Screening (LBM) |
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| Pharmacy Medical Claim Edit |
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| Plasma HIV-1 and HIV-2 RNA Quantification for HIV Infection (LBM) |
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| Prescription Medication and Illicit Drug Testing in Outpatient Setting (LBM) |
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| Prostate Biopsy Specimen Analysis (LBM) |
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| Salivary Hormone Testing (LBM) |
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| Testing For Alpha-1 Antitrypsin Deficiency (LBM) |
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| Testing for Diagnosis of Active or Latent Tuberculosis (LBM) |
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| Testing for Vector-Borne Infections (LBM) |
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| Testing of Homocysteine Metabolism-Related Conditions (LBM) |
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| Testosterone Testing (LBM) |
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| Thyroid Disease Testing (LBM) |
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| Urine Culture Testing for Bacteria (LBM) |
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| Vitamin B12 & Methylmalonic Acid Testing (LBM) |
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| Vitamin D Testing (LBM) |
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| Zika Virus Risk Assessment (LBM) |
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| Allergen Testing (LBM) |
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| Biomarkers for Myocardial Infarction and Chronic Heart Failure (LBM) |
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| Cardiovascular Disease Risk Assessment (LBM) |
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| Diabetes Mellitus Testing (LBM) |
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| Diagnosis of Idiopathic Environmental Intolerance (LBM) |
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| Diagnostic Testing of Iron Homeostasis & Metabolism (LBM) |
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| Erectile Dysfunction (LBM) |
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| Evaluation of Dry Eyes Testing (LBM) |
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| Genetic Testing for Adolescent Idiopathic Scoliosis (LBM) |
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| Identification of Microorganisms Using Nucleic Acid Probes (LBM) |
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| Immune Cell Function Assay (LBM) |
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| Intracellular Micronutrient Analysis (LBM) |
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| Lab Testing for the Diagnosis of IBD (LBM) |
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| Metabolite Markers of Thiopurines Testing (LBM) |
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| Medicare Part D Vaccines |
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| Pancreatic Enzyme Testing for Acute Pancreatitis (LBM) |
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| Pathogen Panel Testing (LBM) |
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| Prenatal Screening-Nongenetic (LBM) |
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| Preventive Screening in Adults (LBM) |
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| Prostate Specific Antigen (PSA) Testing (LBM) |
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| Serum Testing for Evidence of Mild Traumatic Brain Injury (LBM) |
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| Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease (LBM) |
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| Serum Tumor Markers for Malignancies (LBM) |
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| ST2 Assay for Chronic Heart Failure (LBM) |
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| Split/Fragmented Billing |
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| Urinary Tumor Markers for Bladder Cancer (LBM) |
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| Vectra DA Blood Test for Rheumatoid Arthritis (LBM) |
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| Venous and Arterial Thrombosis Risk Testing (LBM) |
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