Ivacaftor (Symdeko) (CP.PHAR.377) (PDF) Tezepelumab (Tezspire) (HIM.PA.176) (PDF) Thalidomide (Thalomid) (CP.PHAR.78) (PDF) Thioguanine (Tabloid) (CP.PHAR.437) (PDF) Thyrotropin Alfa (Thyrogen) (CP.PHAR.95) (PDF) Timothy Grass Pollen Allergen Extract (Grastek) (CP.PMN.84) (PDF) Tiopronin Delayed-Release (Thiola EC) (CP.PHAR.725) (PDF) Tirzepatide (Zepbound) (CP.PMN.298) (PDF) Tisagenlecleucel (Kymriah) (CP.PHAR.361) (PDF) Tislelizumab-jsgr (Tevimbra) (CP.PHAR.687) (PDF) Tisotumab vedotin-tftv (Tivdak) (CP.PHAR.561) (PDF) Tividenofusp Alfa (Avlayah) (CP.PHAR.748) (PDF) Tivozanib (Fotivda) (CP.PHAR.538) (PDF) Tobramycin (Bethkis, Kitabis Pak, TOBI, TOBI Podhaler) (CP.PHAR.211) (PDF) Tofersen (Qalsody) (CP.PHAR.591) (PDF) Tolvaptan (Jynarque, Samsca) (CP.PHAR.27) (PDF) Topical Acne Treatment (HIM.PA.71) (PDF) Topical Immunomodulators (CP.PMN.107) (PDF) Topiramate Extended-Release (Qudexy XR, Trokendi XR) (CP.PMN.281) (PDF) Topotecan (Hycamtin) (CP.PHAR.64) (PDF) Toripalimab-tpzi (Loqtorzi) (CP.PHAR.668) (PDF) Tovorafenib (Ojemda) (CP.PHAR.686) (PDF) Trabectedin (Yondelis, Evdi) (CP.PHAR.204) (PDF) Tradipitant (Nereus) (CP.PMN.307) (PDF) Tralokinumab-ldrm (Adbry) (CP.PCH.60) (PDF) Trametinib (Mekinist) (CP.PHAR.240) (PDF) Trastuzumab Biosimilars Trastuzumab-Hyaluronidase (CP.PHAR.228) (PDF) Travoprost Implant (iDose TR) (CP.PHAR.672) (PDF) Tremelimumab-actl (Imjudo) (CP.PHAR.612) (PDF) Treprostinil (Orenitram, Remodulin, Tyvaso, Tyvaso DPI, Yutrepia) (CP.PHAR.199) (PDF) Triamcinolone ER Injection (Zilretta) (CP.PHAR.371) (PDF) Triclabendazole (Egaten) (CP.PMN.207) (PDF) Trientine (Cuvrior, Syprine) (CP.PHAR.438) (PDF) Trifarotene (Aklief) (CP.PMN.225) (PDF) Trifluridine-tipiracil (Lonsurf) (CP.PHAR.383) (PDF) Triheptanoin (Dojolvi) (CP.PHAR.509) (PDF) Triptorelin pamoate (Trelstar, Triptodur) (CP.PHAR.175) (PDF) Trofinetide (Daybue, Daybue Stix) (CP.PHAR.600) (PDF) Troriluzole (Vyglxia) (CP.PHAR.639)(PDF) Tucatinib (Tukysa) (CP.PHAR.497) (PDF) Ublituximab-xiiy (Briumvi) (CP.PHAR.621) (PDF) Udenafil (CP.PHAR.557) (PDF) Ulcer Therapy Products (CP.PMN.277) (PDF) Uridine triacetate (Vistogard) (HIM.PA.SP55) (PDF) Vadadustat (Vafseo) (CP.PHAR.677) (PDF) Valbenazine (ingrezza, Ingrezza Sprinkle) (CP.PHAR.340) (PDF) Valganciclovir (Valcyte) (CP.PCH.06) (PDF) Valoctocogene Roxaparvovec-rvox (Roctavian) (CP.PHAR.466) (PDF) Valrubicin (Valstar) (CP.PHAR.439) (PDF) Vamorolone (Agamree) (CP.PHAR.659) (PDF) Vandetanib (Caprelsa) (CP.PHAR.80) (PDF) Vanzacaftor/Tezacaftor/Deutivacaftor (Alyftrek) (CP.PHAR.700) (PDF) Varenicline (Tyrvaya) (CP.PMN.273) (PDF) Vatiquinone (PTC743) (CP.PHAR.729) (PDF) Velaglucerase alfa (VPRIV) (CP.PHAR.163) (PDF) Veligrotug (VRDN-001) (CP.PHAR.773) (PDF) Velmanase Alfa-tycv (Lamzede) (CP.PHAR.601) (PDF) Vemurafenib (Zelboraf) (CP.PHAR.91) (PDF) Venetoclax (Venclexta) (CP.PHAR.129) (PDF) Verteporfin (Visudyne) (CP.PHAR.187) (PDF) Vestronidase alfa-vjbk (Mepsevii) (CP.PHAR.374) (PDF) Vigabatrin (Sabril, Vigafyde) (CP.PHAR.169) (PDF) Viloxazine (Qelbree) (CP.PMN.264) (PDF) Viltolarsen (Viltepso) (CP.PHAR.484) (PDF) Vimseltinib (Romvimza) (CP.PHAR.726) (PDF) Vismodegib (Erivedge) (CP.PHAR.273) (PDF) Voclosporin (Lupkynis) (CP.PHAR.504) (PDF) Vorapaxar (Zontivity) (HIM.PA.146) (PDF) Vorasidenib (Voranigo) (CP.PHAR.699) (PDF) Voretigene Neparvovec-rzyl (Luxturna) (CP.PHAR.372) (PDF) Vorinostat (Zolinza) (CP.PHAR.83) (PDF) Vortioxetine (Trintellix) (CP.PMN.65) (PDF) Vosoritide (Voxzogo) (CP.PHAR.525) (PDF) Voxelotor (Oxbryta) (CP.PHAR.451) (PDF) Vusolimogene Oderparepvec (RP1) (CP.PHAR.774) (PDF) Vutrisiran (Amvuttra) (CP.PHAR.550) (PDF) Xanomeline-trospium chloride (Cobenfy) (CP.PMN.299) (PDF) Zanidatamab-hrii (Ziihera) (CP.PHAR.709) (PDF) Zanubrutinib (Brukinsa) (CP.PHAR.467) (PDF) Zavegepant (Zavzpret) (CP.PHAR.630) (PDF) Zenocutuzumab-zbco (Bizengri) (CP.PHAR.713) (PDF) Ziftomenib (Komzifti) (CP.PHAR.765) (PDF) Zilucoplan (Zilbrysq) (CP.PHAR.616) (PDF) Ziv-aflibercept (Zaltrap) (CP.PHAR.325) (PDF) Zolbetuximab-clzb (Vyloy) (CP.PHAR.705) (PDF) Zoledronic Acid (Reclast) (CP.PHAR.59) (PDF) Zongertinib (Hernexeos) (CP.PHAR.750) (PDF) Zopapogene Imadenovec (Papzimeos) (CP.PHAR.730) (PDF) Zuranolone (Zurzuvae) (CP.PHAR.650) (PDF) 340B Drug Payment Reduction (CC.PP.070) (PDF) Add on Code Billed Without Primary Code (CC.PP.030) (PDF) Acute Care Inpatient Hospital Claims - Sepsis Diagnosis (CC.PP.073) (PDF) Allergy Testing and Therapy (TX.CP.MP.100) (PDF) Assistant Surgeon (CC.PP.029) (PDF) Attention Deficit Hyperactivity Disorder Assessment and Treatment (CP.BH.124) (PDF) Bilateral Procedures (CC.PP.037) (PDF) Bronchial Thermoplasty (CP.MP.110) (PDF) Cardiac Biomarker Testing for Acute MI (CP.MP.156) (PDF) Cerumen Removal (CC.PP.008) (PDF) Clinical Validation of Modifier 25 (CC.PP.013) (PDF) Clinical Validation of Modifier 59 (CC.PP.014) (PDF) Code Editing Overview (TX.CC.PP.011) (PDF) Cosmetic Procedures (CC.PP.024) (PDF) Digital Analysis of EEGs (CP.MP.105) (PDF) Distinct Procedural Modifiers (CC.PP.020) (PDF) Drugs of Abuse: Definitive Testing for more than 14 Drugs/Drug Classes (TX.CP.MP.50-A) (PDF) Drugs of Abuse: Presumptive Testing (CP.MP.208) (PDF) Duplicate Primary Code Billing (CC.PP.044) (PDF) E&M Bundling with Lab-Radiology (CC.PP.010) (PDF) E&M Medical Decision-Making (CC.PP.051) (PDF) EEG in the Evaluation of Headache (CP.MP.155) (PDF) Endometrial Ablation (EA) (CP.MP.106) (PDF) Enhanced Code Editing (TX.PP.011-A) (PDF) Evaluation and Management (E/M) Services Billed with Treatment Room Revenue Codes (CC.PP.071) (PDF) Evoked Potentials (CP.MP.134) (PDF) Genetic and Molecular Testing Services (TX.PP.551) (PDF) Genitourinary Lab Testing (TX.CP.MP.307) (PDF) Global Maternity Billing (CC.PP.016) (PDF) Holter Monitors (CP.MP.113) (PDF) Homocysteine Testing (CP.MP.121) (PDF) Hospital Visit Codes Billed with Labs (CC.PP.023) (PDF) Inpatient Claim Reviews (TX.CC.PI.04) (PDF) Infectious Disease: Dermatologic Testing (TX.CP.MP.303) (PDF) Infectious Disease: Gastroenterologic Lab Testing (TX.CP.MP.304) (PDF) Infectious Disease: Multi-System Lab Testing (TX.CP.MP.302) (PDF) Infectious Disease: Respiratory Lab Testing (TX.CP.MP.301) (PDF) Infectious Disease: Vector-Borne and Tropical Diseases Lab Testing (TX.CP.MP.306) (PDF) Inpatient Only Procedures (CC.PP.018) (PDF) Intraoperative Neurophysiology Monitoring (IONM) (TX.CC.PP.503) (PDF) Intravenous Hydration (CC.PP.012) (PDF) Laser Skin Treatment (CP.MP.123) (PDF) Leveling of Care: Emergency Department Evaluation and Management Over-coding for Professional Services (CC.PP.076) (PDF) Leveling of Care: Emergency Department Evaluation and Management Overcoding for Facility Services (CC.PP.80) (PDF) Leveling of Care: Office-based Evaluation and Management Over-coding (CC.PP.066) (PDF) Leveling of Emergency Room Services - Facility (CC.PP.064) Low-frequency Ultrasound Debridement Noncontact Wound Therapy (CP.MP.139) (PDF) Maximum Units of Service (CC.PP.007) (PDF) Measure Serum 1,25 Vitamin D (CP.MP.152) (PDF) Mechanical Stretch Devices (CP.MP.144) (PDF) Moderate Conscious Sedation (CC.PP.015) (PDF) Modifier DOS Validation (CC.PP.034) (PDF) Modifier to Procedure Code Validation (CC.PP.028) (PDF) Multiple CPT Code Replacement (CC.PP.033) (PDF) Multiple Procedure Payment Reduction (MPPR) for Diagnostic Cardiovascular Procedures (CC.PP.065) (PDF) NCCI Unbundling (CC.PP.031) (PDF) Never Paid Events (CC.PP.017) (PDF) Newborn Inpatient Stays (TX.CC.PP.075) (PDF) New Patient (CC.PP.036) (PDF) Non-obstetrical and Obstetrical Transabdominal and Transvaginal Ultrasounds (CC.PP.061) (PDF) Not Medically Necessary Inpatient Professional Services (CC.PP.060) (PDF) Outpatient Consultation (CC.PP.039) (PDF) Physician Visit Codes Billed with Labs (CC.PP.019) (PDF) Place of Service Mismatch (CC.PP.063) (PDF) Post-Operative Visits (CC.PP.042) (PDF) Pre-Operative Visits (CC.PP.041) (PDF) Primary Care and Preventive Lab Screening (TX.CP.MP.305) (PDF) Problem Oriented Visits Billed with Preventative Visits (CC.PP.057) Problem Oriented Visits Billed with Surgical Procedures (CC.PP.052) Professional Component Modifier (CC.PP.027) (PDF) Pulmonary Function Testing (CP.MP.242) (PDF) Pulse Oximetry with Office Visits (CC.PP.025) (PDF) Renal Hemodialysis (CC.PP.067) (PDF) Robotic Surgery (CC.PP.050) (PDF) Same Day Visits (CC.PP.040) (PDF) Severe Malnutrition (CC.PP.145) (PDF) Sleep Studies Place of Services (CC.PP.035) (PDF) Status "B" Bundled Services (CC.PP.046) (PDF) Status "P" Bundled Services (CC.PP.049) (PDF) Supplies Billed on Same Day As Surgery (CC.PP.032) (PDF) Thyroid Testing in Pediatrics (CP.MP.154) (PDF) Transgender Related Services (CC.PP.047) (PDF) Ultrasound in Pregnancy (CP.MP.38) (PDF) Unbundled Professional Services (CC.PP.043) (PDF) Unbundled Surgical Procedures (CC.PP.045) (PDF) Unlisted Procedure Codes (CC.PP.009) (PDF) Urine Specimen Validity Testing (CC.PP.056) (PDF) Urodynamic Testing (CP.MP.98) (PDF) Vitamin D Testing in Children (CP.MP.157) (PDF) Wheelchair and Accessories (CC.PP.502) (PDF) Wireless Motility Capsule (CP.MP.143) (PDF) Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) and CHIP Policies ADHD Assessment and Treatment (CP.BH.124) (PDF) Allergy Testing and Therapy (TX.CP.MP.100) (PDF) Allogeneic Hematopoietic Cell Transplants for Sickle Cell Anemia and -Thalassemia (CP.MP.108) (PDF) Assistive Communication Device (TX.CP.MP.551) (PDF) Bone-Anchored Hearing Aid (TX.CP.MP.522) (PDF) Burn Surgery (CP.MP.186) (PDF) Caudal or Interlaminar Epidural Steroid Injections (CP.MP.164) (PDF) Child and Adolescent Strength and Needs (CANS) 3.0 Medical Necessity Criteria (TX.CP.MP.543) (PDF) Clinical Trials (CP.MP.94)- CHIP only (PDF) Cognitive Rehabilitation Therapy (TX.CP.MP.553) (PDF) Cosmetic and Reconstructive Procedures (CP.MP.31) (PDF) Cranial Remolding Orthosis (TX.CP.MP.523) (PDF) Custom Mobility Seating and Systems (TX.CP.MP.599) (PDF) Dental Therapy Under General Anesthesia (TX.CP.MP.518) (PDF) Diabetic Supplies (TX.CP.MP.526) (PDF) Diaphragmatic/Phrenic Nerve Stimulation (CP.MP.203) (PDF) Donanemab-azbt (Kisunla) (TX.CC.PHAR.47) (PDF) Donor Lymphocyte Infusion (CP.MP.101) (PDF) Drugs of Abuse: Definitive Testing (CP.MP.50) (PDF) Durable Medical Equipment and Orthotics and Prosthetics Guidelines (CP.MP.107) (PDF) Durable Medical Equipment and Medical Supplies (TX.CP.MP.552) (PDF) Elective Deliveries Before 39 Weeks Gestational Age (TX.CP.MP.513) (PDF) Electric Tumor Treating Fields (Optune) (CP.MP.145) (PDF) Enteral Nutrition and Supplies (TX.CP.MP.550) (PDF) Eptinezumab-jjmr (Vyepti) (CP.PHAR.489) (PDF) Excision of Lesions (TX.CP.MP.525) (PDF) Experimental Technologies (CP.MP.36) - for CHIP only (PDF) Facet Joint Interventions (CP.MP.171) (PDF) Facility-based Sleep Studies for Obstructive Sleep Apnea (CP.MP.248) (PDF) Fecal Incontinence Treatments (CP.MP.137) (PDF) Fetal Surgery In Utero for Prenatally Diagnosed Malformations (CP.MP.129) (PDF) Gastric Electrical Stimulation (CP.MP.40) (PDF) Home Ventilators- CHIP Only (CP.MP.184) (PDF) Heart-Lung Transplant (CP.MP.132) (PDF) Hyaluronate Derivatives (Viscosupplementation) (TX.CP.MP.505) (PDF) Hyperhidrosis Treatments (CP.MP.62) (PDF) Implantable Hypoglossal Nerve Stimulation (CP.MP.180) (PDF) Implantable Intrathecal or Epidural Pain Pump (CP.MP.173) (PDF) Implantable Loop Recorder (CP.MP.243) (PDF) Implantable Wireless Pulmonary Artery Pressure Monitoring (CP.MP.160) (PDF) Intestinal and Multivisceral Transplant (CP.MP.58) (PDF) Intradiscal Steriod Injections (CP.MP.167) (PDF) Lecanemab-irmb (Leqembi) (TX.CC.PHAR.27) (PDF) Low-Frequency Ultrasound and Noncontact Normothermic Wound Therapy (CP.MP.139) (PDF) Lung Transplantation (CP.MP.57) (PDF) Mastectomy for Pubertal Gynecomastia (TX.CP.MP.571) (PDF) Mechanical Stretch Devices for Joint Stiffness and Contracture (CP.MP.144) (PDF) Mental Health Rehabilitation and Target Case Management Services (TX.CP.BH.544) (PDF) Medical Necessity Criteria (TX.CP.MP.500) (PDF) Multiple Sleep Latency Testing (CP.MP.24) (PDF) Neonatal Abstinence Syndrome Guidelines (CP.MP.86) (PDF) Neonatal Sepsis Management (CP.MP.85) (PDF) Nerve Blocks and Neurolysis for Pain Management (CP.MP.170) (PDF) Neuromuscular and Peroneal Nerve Electrical Stimulation (NMES) (CP.MP.48) (PDF) NICU Apnea Bradycardia Guidelines (CP.MP.82) (PDF) NICU Discharge Guidelines (CP.MP.81) (PDF) Nogapendekin alfa inbakicept-pmln (Anktiva) (TX.CC.PHAR.42) (PDF) Non-Emergent Ambulance Transportation (TX.CP.MP.507) (PDF) Non-Myeloablative Allogeneic Stem Cell Transplants (CP.MP.141) (PDF) Obstetrical Home Care Programs (CP.MP.91) (PDF) Orthognathic Surgery (CP.MP.202) (PDF) Osteogenic Stimulation (CP.MP.194) Pancreas Transplatation (CP.MP.102) (PDF) Panniculectomy (CP.MP.109) (PDF) Pediatric Heart Transplant (CP.MP.138) (PDF) Pediatric Kidney Transplant (CP.MP.246) (PDF) Pediatric Liver Transplant (CP.MP.120) (PDF) Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention (CP.MP.147) (PDF) Phototherapy for Neonatal Hyperbilirubinemia (CP.MP.150) (PDF) Physical, Occupational and Speech Therapy Services (TX.CP.MP.549) (PDF) Private Duty Nursing (TX.CP.MP.520) (PDF) Private Duty Nursing - for CHIP only (TX.CP.MP.521) (PDF) Reduction mammoplasty & Gynecomastia Surgery (CP.MP.51) (PDF) Sacroiliac Joint Interventions for Pain Management (CP.MP.166) (PDF) Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins and Other Symptomatic Venous Disorders (CP.MP.146) (PDF) Selective Nerve Root Blocks and Transforaminal Epidural Steroid Injections (CP.MP.165) (PDF) Short Inpatient Hospital Stay (TX.CP.MP.582) (PDF) Skilled Nursing Visits (TX.CP.MP.538) (PDF) Skin and Soft Tissue Substitutes for Diabetic Foot Ulcers and Venous Leg Ulcers (CP.MP.185) (PDF) Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation (CP.MP.117) (PDF) Tandem Transplant (CP.MP.162) (PDF) Tarlatamab-dlle (Imdelltra) (TX.CC.PHAR.43) (PDF) Therapeutic Utilization of Inhaled Nitric Oxide (CP.MP.87) (PDF) Total Artificial Heart (CP.MP.127) (PDF) Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (CP.MP.163) - for CHIP only (PDF) Transplant Service Documentation Requirements (CP.MP.247) (PDF) Urinary Incontinence Devices and Treatments (CP.MP.142) (PDF) Vagus Nerve Stimulation (CP.MP.12) (PDF) Ventricular Assist Devices (CP.MP.46) (PDF) Please note: The policies listed below are used for medically billed drugs only
This article was originally published on WBUR.org
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