ConnectiCare has made updates to the following reimbursement policies, medical policies, and payment integrity policies for our commercial (employer group) members. See the revision histories for changes and their effective dates.
Reimbursement policies:
- Bundled Services
- Coding Edits Policy
- Hospital Readmissions
- Modifier Reference Policy
- National Drug Code (NDC) Requirements for Drug Claims
Lab Benefit Management (LBM) reimbursement policies:
- Allergen Testing (LBM)
- Biomarker Testing for Autoimmune Rheumatic Disease (LBM)
- Cardiovascular Disease Risk Assessment (LBM)
- Colorectal Cancer Screening (LBM)
- Diagnosis of Vaginitis (LBM)
- Diagnostic Testing of Common Sexually Transmitted Infections (LBM)
- Epithelial Cell Cytology in Breast Cancer Risk Assessment (LBM)
- Evaluation of Dry Eyes Testing (LBM)
- Flow Cytometry (LBM)
- Folate Testing (LBM)
- Helicobacter Pylori Testing (LBM)
- Hepatitis Testing (LBM)
- Human Immunodeficiency Virus (HIV) (LBM)
- Lyme Disease Testing (LBM)
- Micronutrient Testing (LBM) (Previously titled Intracellular Micronutrient Analysis (LBM))
- Onychomycosis Testing (LBM)
- Pancreatic Enzyme Testing for Acute Pancreatitis (LBM)
- Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing (LBM)
- Pediatric Preventive Screening (LBM)
- Prescription Medication and Illicit Drug Testing in the Outpatient Setting (LBM)
- Prostate Specific Antigen (PSA) Testing (LBM)
- Salivary Hormone Testing (LBM)
- Serum Tumor Markers for Malignancies (LBM)
- Thyroid Disease Testing (LBM)
- Urinary Tumor Markers for Bladder Cancer (LBM)
- Venous and Arterial Thrombosis Risk Testing (LBM)
Payment integrity policies:
- Device, Implant and Skin Substitutes Coding Guidelines (Facilities)
Medical policies:
- Experimental Investigational or Unproved Services Policy
