ND Committee Review
Internal Medical Policy Committee 1-19-2021 Annual Review
Internal Medical Policy Committee 1-20-2022 Annual Review-no changes in criteria
Internal Medical Policy Committee 3-23-2022 Revision
- Revised
with clarifying language.
Internal Medical Policy Committee 3-23-2023 Annual Review-no changes in criteria
Internal Medical Policy Committee 7-26-2023 Coding update -
Effective September 04, 2023
- Removed
diagnosis code H35.311
Internal Medical Policy Committee 11-15-2023 Coding update -
Effective October 01, 2023
- Added
diagnosis codes H36.811, H36.812, H36.813, H36.819, H36.821, H36.822, H36.823, H36.829, and H36.89 to procedure codes 0509T, 92273, and 92274.
Internal Medical Policy Committee 11-19-2024 Annual Review -no changes in criteria
