ND Committee Review
Internal Medical Policy Committee 1-22-2020 adding codes
Internal Medical Policy Committee 1-19-2021 Coding update
- Added
Diagnosis Codes: F10.130, F10.131, F10.132, F10.139, F10.930, F10.931, F10.932, F10.939, F11.13, F12.13, F13.130, F13.131, F13.132, F13.139, F14.13, F14.93, F15.13, F19.130, F19.131, F19.132, F19.139
Internal Medical Policy Committee 9-21-2021 Revision with coding updates
Added
criteria from M-80 Electroencephalogram for Headaches;
and
Removed
Diagnosis code R40;
and
Added
Diagnosis codes for procedure codes 95812, 95813, 95816 and 95819
- G44.001, G44.009, G44.011, G44.019, G44.021, G44.029, G44.031, G44.039, G44.041, G44.049, G44.051, G44.059, G44.091, G44.099, G44.1, G44.201, G44.211, G44.219, G44.221, G44.229, G44.301, G44.309, G44.311, G44.319, G44.321, G44.329, G44.40; G44.41, G44.51, G44.52, G44.53, G44.59, G44.81, G44.82, G44.83, G44.84, G44.85, G44.86, G44.89, R51.0, R51.9;
and
Internal Medical Policy Committee 5-24-2022 Revision with coding updates
- Removed
the following Procedure codes 95700; 95712; 95713; 95715 and 95716;
and
- Added
the following Procedure codes 95708; 95717; 95719; 95721; 95723; 95725; 95812; 95813; 95816; 95819 and 95822;
and
- Removed
the following Diagnosis codes F10.11; F11.11; F11.23; F13.11; F11.93; F13.11; F14.11; F14.23; F15.11; F16.11; F18.11; F19.11; G40.11; P10.0; R40.2130; R40.2131; R40.2132; R40.2133; R40.2134; R40.2140; R40.2141; R40.2142; R40.2143; R40.2144; R40.2230; R40.2231; R40.2232; R40.2233; R40.2234; R40.2240; R40.2241; R40.2242; R40.2243; R40.2244; R40.2250; R40.2251; R40.252; R40.2253; R40.2254; R40.2330; R40.2331; R40.2332; R40.2333; R40.2334; R40.2360; R40.2363; R40.2410; R40.2411; R40.2412; R40.2413; R40.2414; R40.2420; R40.2421; R40.2422; R40.2423; R40.2430; R40.2431; R40.2432; R40.2433; R40.4234; R40.2440; R40.2441; R40.2442; R40.2443; R40.2444; R40.3; R56.1 and R56.9;
and
- Added
too many diagnosis codes to individually list here (see policy).
Internal Medical Policy Committee 9-28-2022 Coding update -
Effective October 01, 2022
- Removed
Diagnosis codes E87.2; and I47.2;
and
- Added
Diagnosis codes I47.20; I47.29; S06.1XAA; S06.1XAD; S06.1XAS; S06.2XAA; S06.2XAD; S06.2XAS; S06.30AA; S06.30AD; S06.30AS; S06.89AA; S06.89AD; S06.89AS; S06.9XAA; S06.9XAD; and S06.9XAS
Internal Medical Policy Committee 3-23-2023 Coding update -
Effective May 01, 2023
- Removed
Procedure code P28.4;
and
- Added
Procedure codes P28.40; P28.41; P28.42; P28.43 and P28.49
Internal Medical Policy Committee 11-15-2023 Coding update -
Effective October 01, 2023
- Added P
rocedure codes E88.43, G23.3; G37.81; G37.89; G93.42; G93.43; and G93.44;
and
- Removed
Procedure codes G20; and G37.8.
Internal Medical Policy Committee 9-17-2024 Coding update - Effective
October 01, 2024
- Added
diagnosis codes for procedure codes
95700; 95705; 95706; 95707; 95708; 95709; 95710; 95711; 95712; 95713; 95714; 95715; 95716; 95717; 95718; 95719; 95720; 95721; 95722; 95723; 95724; 95725; 95726; 95812; 95813; 95816; 95819; 95822; and 99184
- E74.820; E74.829; G40.841; G40.842; G40.843; G40.844; G90.81; G90.89; and G93.45.
- Removed
diagnosis code G90.8
for procedure codes
95700; 95705; 95706; 95707; 95708; 95709; 95710; 95711; 95712; 95713; 95714; 95715; 95716; 95717; 95718; 95719; 95720; 95721; 95722; 95723; 95724; 95725; 95726; 95812; 95813; 95816; 95819; 95822; and 99184;
- Added
Policy Application
Internal Medical Policy Committee 11-19-2024 Annual Review -no changes in criteria