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On Feb. 21, 2024, Change Healthcare experienced a cyber security incident. Any individuals impacted by this incident will receive a letter in the mail. To learn more about this from Change Healthcare, please visit the Change Healthcare website or reach out to the contact center at 1-866-262-5342. More from Change Healthcare

Important: Medicare Policies Effective January 1, 2024

New Policies for Medicare

•      MC.CP.MP.170 Peripheral Nerve Blocks

•      MC.CP.MP.22 Stereotactic Body Radiation Therapy

•      MC.CP.MP.69 Intensity-Modulated Radiotherapy

•      MC.CP.MP.246 Pediatric Kidney Transplantation

•      MC.CP.MP.57 Lung Transplantation

•      MC.CP.MP.101 Donor Lymphocyte Infusion

•      MC.CP.MP.108 Allogeneic Hematopoietic Cell Transplants for Sickle Cell Anemia and Beta-thalassemia

•      MC.CP.MP.182 Short Inpatient Stay

•      MC.CP.MP.106 Endometrial Ablation

•      MC.CP.MP.160 Wireless Pulmonary Artery Monitoring

•      CP.PP.206 Skilled Nursing Facility Leveling

•      V2.2023 Concert Genetics Genetic Testing Aortopathies and Connective Tissue Disorders

•      V2.2023 Concert Genetics Genetic Testing Cardiac Disorders

•      V2.2023 Concert Genetics Genetic Testing Dermatologic Conditions

•      V2.2023 Concert Genetics Genetic Testing Epilepsy, Neurodegenerative, and Neuromuscular Conditions

•      V2.2023 Concert Genetics Genetic Testing Exome and Genome Sequencing for the Diagnosis of Genetic Disorders

•      V2.2023 Concert Genetics Genetic Testing Eye Disorders

•      V2.2023 Concert Genetics Genetic Testing Gastroenterologic Disorders (non-cancerous)

•      V2.2023 Concert Genetics Genetic Testing General Approach to Genetic Testing

•      V2.2023 Concert Genetics Genetic Testing Hearing Loss

•      V2.2023 Concert Genetics Genetic Testing Hematologic Condition (non-cancerous)

•      V2.2023 Concert Genetics Genetic Testing Hereditary Cancer Susceptibility

•      V2.2023 Concert Genetics Genetic Testing Immune, Autoimmune, and Rheumatoid Disorders

•      V2.2023 Concert Genetics Genetic Testing Kidney Disorders

•      V2.2023 Concert Genetics Genetic Testing Lung Disorders

•      V2.2023 Concert Genetics Genetic Testing Metabolic, Endocrine, and Mitochondrial Disorders

•      V2.2023 Concert Genetics Genetic Testing Multisystem Inherited Disorders, Intellectual Disability, and Developmental Delay

•      V2.2023 Concert Genetics Genetic Testing Non-Invasive Prenatal Screening (NIPS)

•      V2.2023 Concert Genetics Genetic Testing Pharmacogenetics

•      V2.2023 Concert Genetics Genetic Testing Preimplantation Genetic Testing

•      V2.2023 Concert Genetics Genetic Testing Prenatal and Preconception Carrier Screening

•      V2.2023 Concert Genetics Genetic Testing Prenatal Diagnosis via Amniocentesis, CVS or PUBS and Pregnancy Loss

•      V2.2023 Concert Genetics Genetic Testing Skeletal Dysplasia and Rare Bone Disorders

•      V2.2023 Concert Genetics Oncology Algorithmic Testing

•      V2.2023 Concert Genetics Oncology Cancer Screening

•      V2.2023 Concert Genetics Oncology Circulating Tumor DNA and Circulating Tumor Cells Liquid Biopsy

•      V2.2023 Concert Genetics Oncology Cytogenetic Testing

•      V2.2023 Concert Genetics Oncology Molecular Analysis of Solid Tumors and Hematologic Malignancies

Policies with updates

•      CP.CPC.05 Medical Necessity Criteria Hierarchy

•      Clinical Practice Guidelines

Policies Retired for Medicare

•      CP.MP.100 Allergy Testing and Therapy

•      CP.MP.101 Donor Lymphocyte Infusion

•      CP.MP.102 Pancreas Transplant

•      CP.MP.105 Digital EEG Analysis

•      CP.MP.106 Endometrial Ablation

•      CP.MP.107 Durable Medical Equipment and Orthotics and Prosthetics Guidelines

•      CP.MP.108 Allogeneic Hematopoietic Cell Transplants For Sickle Cell Anemia and Beta-thalassemia

•      CP.MP.109 Panniculectomy

•      CP.MP.110 Bronchial Thermoplasty

•      CP.MP.113 Holter Monitors

•      CP.MP.114 Disc Decompression Procedures

•      CP.MP.115 Discography

•      CP.MP.116 Lysis of Epidural Lesions

•      CP.MP.117 Spinal Cord Stimulation

•      CP.MP.12 Vagus Nerve Stimulation

•      CP.MP.120 Pediatric Liver Transplant

•      CP.MP.121 Homocysteine Testing

•      CP.MP.123 Laser Therapy for Skin Conditions

•      CP.MP.126 Sacroiliac Joint Infusion

•      CP.MP.127 Total Artificial Heart

•      CP.MP.128 Optic Nerve Decompression Surgery

•      CP.MP.129 Fetal Surgery in Utero for Prenatally Diagnosed Malfunctions

•      CP.MP.130 Fertility Preservation

•      CP.MP.132 Heart-Lung Transplant

•      CP.MP.133 Posterior Tibial Nerve Stimulation for Voiding Dysfunction

•      CP.MP.134 Evoked Potential Testing

•      CP.MP.136 Home Births

•      CP.MP.137 Fecal Incontinence Treatments

•      CP.MP.138 Pediatric Heart Transplant

•      CP.MP.139 Low-frequency Ultrasound and Noncontact Wound Therapy

•      CP.MP.14 Cochlear Implant Replacements

•      CP.MP.141 Non-myeloablative Allogeneic Stem Cell Transplants

•      CP.MP.142 Urinary Incontinence Devices and Treatments

•      CP.MP.143 Wireless Motility Capsule

•      CP.MP.144 Mechanical Stretching Devices for Joint Stiffness and Contracture

•      CP.MP.145 Electric Tumor Treating Fields (Optune)

•      CP.MP.146 Sclerotherapy for Chemical Endovenous Ablation for Varicose Veins

•      CP.MP.147 Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention

•      CP.MP.148 Radial Head Implant

•      CP.MP.150 Phototherapy for Neonatal Hyperbilirubinemia

•      CP.MP.151 Transcatheter Closure of Patent Foramen Ovale

•      CP.MP.152 Measurement of Serum 1,25-dihydroxyvitamin D

•      CP.MP.153 Helicobacter Pylori (H Pylori) Serology Testing

•      CP.MP.154 Thyroid Hormones and Insulin in Pediatrics

•      CP.MP.155 EEG Headache

•      CP.MP.156 Cardiac Biomarker Testing

•      CP.MP.157 25-hydroxyvitamin D Testing in Children and Adolescents

•      CP.MP.158 Ambulatory Surgery Center Optimization

•      CP.MP.160 Implantable Wireless Pulmonary Artery Pressure Monitoring

•      CP.MP.162 Tandem Transplant

•      CP.MP.163 Total Parenteral Nutrition and Intradialytic Parenteral Nutrition

•      CP.MP.164 Caudal or Interlaminar Epidural Steroid Injections

•      CP.MP.165 Selective Nerve Root Blocks and Transforaminal Epidural Injections

•      CP.MP.166 Sacroiliac Joint Interventions for Pain Management

•      CP.MP.167 Intradiscal Steroid Injections for Pain Management

•      CP.MP.168 Biofeedback

•      CP.MP.169 Trigger Point Injections for Pain Management

•      CP.MP.170 Nerve Blocks for Pain

•      CP.MP.171 Facet Joint Interventions

•      CP.MP.173 Implantable Intrathecal or Pain Pump

•      CP.MP.174 Selective Dorsal Rhizotomy for Spasticity in Cerebral Palsy

•      CP.MP.175 Air Ambulance

•      CP.MP.176 Outpatient Cardiac Rehabilitation

•      CP.MP.180 Implantable Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea

•      CP.MP.181 Polymerase Chain Reaction Respiratory Viral Panel Testing

•      CP.MP.182 Short Inpatient Hospital Stay

•      CP.MP.184 Home Ventilators

•      CP.MP.185 Skin and Soft Tissue Substitutes for Chronic Wounds

•      CP.MP.186 Burn Surgery

•      CP.MP.188 Pediatric Oral Function Therapy

•      CP.MP.190 Outpatient Oxygen Use

•      CP.MP.194 Osteogenic Stimulation

•      CP.MP.202 Orthognathic Surgery

•      CP.MP.203 Diaphragmatic Phrenic Nerve Stimulation

•      CP.MP.206 Skilled Nursing Facility Leveling

•      CP.MP.209 Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing

•      CP.MP.210 Repair of Nasal Valve Compromise

•      CP.MP.22 Stereotactic Body Radiation Therapy

•      CP.MP.24 Multiple Sleep Latency Testing

•      CP.MP.242 Pulmonary Function Testing

•      CP.MP.243 Implantable Loop Recorder

•      CP.MP.244 Liposuction for Lipedema

•      CP.MP.246 Pediatric Kidney Transplant

•      CP.MP.247 Transplant Service Documentation Requirements

•      CP.MP.248 Facility Based Sleep Studies for OSA

•      CP.MP.26 Articular Cartilage Defect Repair

•      CP.MP.31 Cosmetic and Reconstructive Surgery

•      CP.MP.36 Experimental Technologies

•      CP.MP.37 Bariatric Surgery

•      CP.MP.38 Ultrasound in Pregnancy

•      CP.MP.40 Gastric Electrical Stimulation

•      CP.MP.43 Functional MRI

•      CP.MP.46 Ventricular Assist Devices

•      CP.MP.48 Neuromuscular and Peroneal Nerve Electric Stimulation

•      CP.MP.49 Physical Occupational and Speech Therapy Services

•      CP.MP.50 Drugs of Abuse Definitive Testing

•      CP.MP.51 Reduction Mammoplasty and Gynecomastia Surgery

•      CP.MP.53 Ferriscan R2-MRI

•      CP.MP.54 Hospice

•      CP.MP.55 Assisted Reproductive Technology

•      CP.MP.57 Lung Transplantation

•      CP.MP.58 Intestinal and Multivisceral Transplant

•      CP.MP.61 IV Moderate Sedation IVE Deep Sedation and General Anesthesia for Dental Procedures

•      CP.MP.62 Hyperhidrosis Treatments

•      CP.MP.69 Intensity Modulated Radiotherapy

•      CP.MP.70 Proton and Neutron Beam Therapies

•      CP.MP.71 Long Term Care Placement Criteria

•      CP.MP.81 NICU Discharge Guidelines

•      CP.MP.82 NICU Apnea Bradycardia

•      CP.MP.85 Neonatal Sepsis Management

•      CP.MP.86 Neonatal Abstinence Syndrome Guidelines

•      CP.MP.87 Therapeutic Utilization of Inhaled Nitric Oxide

•      CP.MP.91 Obstetrical Home Care Programs

•      CP.MP.92 Acupuncture

•      CP.MP.93 Bone-Anchored Hearing Aid

•      CP.MP.94 Clinical Trials

•      CP.MP.95 Gender-Affirming Procedures

•      CP.MP.98 Urodynamic Testing

•      CP.MP.99 Wheelchair Seating

•      CP.BH.100 Substance Use Disorders and Treatment Services

•      CP.BH.104 Applied Behavioral Analysis

•      CP.BH.124 ADHD

•      CP.BH.200 TMS for Treatment Resistant Major Depression

•      CP.BH.201 Deep Transcranial Magnetic Stimulation for Treatment of Obsessive-Compulsive Disorder

•      CP.BH.300 Biofeedback for BH Disorders