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News and Publications Medical Review News and Publications

Topic Publication Date Last Revised/Reviewed
Date of Service Policy 06.30.2026  
TPE Provider Contact Information 01.15.2026  
PXR Response to Comments 12.15.2025  
Claim Resubmission/Rebilling 04.22.2025  
Billing Not Otherwise Classified (NOC) HCPCS Code 03.18.2025  
Billing the Professional and Technical Components 02.27.2025  
Proper Billing of Tuberculosis Tests 07.16.2024  
Utilizing Modifier KX for Medicare Dental Claims 07.01.2024  
Documentation Guidelines for Evaluation & Management (E/M) Services: Reminders and Updates 04.09.2024  
Billing and Coding: JW and JZ Modifier Guidelines 06.27.2023  
When You Don't Respond to Additional Documentation Requests (ADRs): Quick Reference GuidePDF 06.16.2023  
Medicare Dental Service Coverage Update 06.08.2023  
J15 Targeted Probe Educate Review Status 05.25.2023  
Targeted Probe and Educate Program to Focus on Laboratory Testing 05.25.2023  
Targeted Probe and Educate Program to Focus on Annual Wellness Visits 05.25.2023  
SPRAVATO™ (esketamine) nasal spray, CIII 05.01.2023 12.21.2023
NCD 110.24: Chimeric Antigen Receptor (CAR) T-Cell Therapy Billing Instructions 03.10.2023  
Targeted Probe and Education Program to Focus on Spinal Pain Management Claims 01.04.2023  
MolDX: Pharmacogenomics Testing Policy Article Update 03.14.2022  
Triamcinolone Acetonide Injectable Suspension, for Suprachoroidal Use (Xipere™) Billing and Coding Instructions 01.25.2022  
Sinus Implant Billing and Coding Instructions 01.21.2022  
Radioactive Diagnostic Agents for Positron Emission Tomography (PET) of Prostate-Specific Membrane Antigen (PSMA) Positive Lesions in Men with Prostate Cancer Billing and Coding Instructions 01.20.2022  
Billing VEKLURY™ (Remdesivir) Antiviral Medication in Outpatient Settings 01.18.2022  
Qutenza (capsaicin 8% topical system) Billing and Coding Instructions 11.08.2021  
Piflufolastat F-18 ("Pylarify")(18F-DCFPyl or PyL) Billing and Coding Instructions 10.21.2021  
Targeted Probe and Educate (TPE) Process 09.02.2021  
Split/Shared Services 03.22.2021 07.16.24
J15 Post Pay Resumptive Review Status Update 08/17/2020 – 12/31/2020 03.02.2021  
J15 Targeted Probe and Educate Status Update July 1, 2019 – September 30, 2019 11.22.2019  
J15 Targeted Probe and Educate Status Update: April 1, 2019 – June 30, 2019 08.29.2019  
Prolonged Services (CPT Codes 99354 – 99359) 08.21.2019  
Q4 J15 Targeted Probe and Educate Status Update 02.01.2019  
CGS Part B Reviews of Frequency of E/M Office Visits 10.30.2018  
Policy Updates: New, Retired, Annual ICD-10 Changes 10.23.2018  
Portable X-Ray Benefit 09.19.2018  
Who May Report CPT Codes 99304 – 99306 Initial Nursing Facility Care 09.18.2018  
Independent Diagnostic Testing Facility (IDTF) Performance Standards (V10) 05.02.2018 10.16.2020
How to Avoid Lab Errors 02.27.2018 08.06.2018
What Are Acceptable Electronic Signature Notations? 09.26.2017 01.14.2022
Important: JW Modifier Use Change Effective July 1, 2016 06.01.2016 06.20.2016
CGS-MolDX: Next Generation Sequencing (NGS) and Tier 1 and Tier 2 Coding and Billing Guidelines (CM00096) 02.09.2016  
Signatures and Compliance: Practitioner Offices and Billing Services 03.06.2014 12.13.2023
Teaching Physician Services: Supervision, Documentation, and HCPCS Modifier GC 09.19.2013 05.07.2019
Breast Tomosynthesis: Coverage and Claim Submission Instructions 09.06.2013 01.13.2015
Invoice Claim Filing Instructions 03.07.2013  

Updated: 06.30.2026
Reviewed: 06.30.2026

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