Clinical Payment and Coding Policy Updates 

August 14, 2024

Clinical Payment and Coding Policies  describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10 coding for claims submitted as covered services. This information is a resource for our payment policies. It’s not intended to address all reimbursement-related issues. We regularly add and modify clinical payment and coding policy positions as part of our ongoing policy review process.  

The following policies were updated:  

  • CPCP001: Observation Services Policy – Effective 8/8/24  
  • CPCP003: Evaluation and Management of Emergency Department Coding – Effective 7/29/24   
  • CPCP004: Neonatal Intensive Care Unit Level of Care Authorization and Reimbursement Policy – Effective 7/29/24   
  • CPCP026: Therapeutic, Prophylactic and Diagnostic Injection and Infusion Coding – Effective 8/8/24   
  • CPCP031: Trauma Activation – Facility Services – Effective 7/29/24   
  • CPCPLAB059: Diagnosis of Vaginitis including Multi-target PCR Testing – Archived Effective 8/7/24 

 

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