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PA and Policy Updates

PA and Policy Updates 

PA's and Policy Update Notifications Since September 1, 2024

For notifications delivered prior to September 1 please see Updates page.

Procedure Code

Procedure Code Description

New Standard
Line of Business

19303

MASTECTOMY, SIMPLE, COMPLETE

Pre-authorization is required for All Providers

Medicaid


New Payment Policy: Leveling of Care: Evaluation and Management Overcoding Effective 12-1-24 (All Products)

Payment Policy CC.PP.066: Physician medical records should chronologically report the care a patient received and record pertinent facts, findings, and observations about the patient’s health history. See our Policy Website Page for full details.