Reimbursement / Claims Policies

Medica's Reimbursement Policies provide guidance for providers to code and submit claims to Medica for covered health care services. These Reimbursement Policies are provided in conjunction with other Medica policies and procedures, including, but not limited to any applicable participating provider contract, provider manual, administrative manual and credentialing plan.


DME Reimbursement Policies

• Conductive Gels and Paste (2/07)
• Oxygen Reimbursement Policy
• Power Mobility Devices and Power Wheelchairs and POVs (2/07)

Policies

	Acupuncture with Evaluation and Management Services
	Evaluation and Management Code List 2009
	Anesthesia Policy
	Anesthesia Single Case List Anesthesia Unbundled Services List Anesthesia Add-On Code List Anesthesia Qualifying Circumstances Codes Anesthesia RBRVS List Moderate Sedation Policy
	Assistant Surgeon Services Policy
	Assistant Surgeon Eligible List 2009 Assistant Surgeon Eligible List 2008 Assistant Surgeon Eligible List 2007 Assistant Surgeon Eligible List 2006 Assistant Surgeon Eligible List 2005
	Bilateral Procedures Policy
	Bilateral Eligible List 2009 Bilateral Eligible List 2008 Bilateral Eligible List 2007 Bilateral Eligible List 2006 Bilateral Eligible List 2005
	Bundled Services Policy
	Medica Medicare Bundled Services Code List Medica Commercial and Medicaid Bundled Services Code List Medica Commercial and Medicaid – Status “B” Codes Eligible for Reimbursement
	Care Plan Oversight Policy
	Co-Surgeon / Team Surgeon Services Policy
	Co-Surgeon Eligible List 2009 Team Surgeon Eligible List 2009 Co-Surgeon Eligible List 2008 Team Surgeon Eligible List 2008 Co-Surgeon Eligible List 2007 Team Surgeon Eligible List 2007 Co-Surgeon Eligible List 2006 Team Surgeon Eligible List 2006
	Facet Joint Injections Policy
	Global Days Policy
	Initial Inpatient Consultations Policy
	Injections of the Tendon Sheath, Ligament, Ganglion Cyst, Carpal or Tarsal Tunnels
	Laboratory Services Policy
	Multiple Procedures Policy
	Multiple Surgical Reduction Eligible List 2007 Multiple Surgical No Reduction Eligible List 2007 Multiple Surgical Reduction Eligible List 2006 Multiple Surgical No Reduction Eligible List 2006
	Nerve Blocks Transforaminal Epidural Injections Policy
	Nerve Conduction Studies / Electromyography
	New Patient Visits Policy
	Obstetrical Services Policy
	Polysomnography
	Professional and Technical Components Policy
	Professional and Technical Status Indicator 5 Policy
	Professional and Technical Status Indicator 5 Code List 2009
	Rebundling Policy
	Same Day Services Policy
	Self-Administered Drugs Claims Policy
	Standby Physician Policy
	Telehealth Policy
	Therapeutic Injection Policy
	Trigger Point Injections
	Unlisted Surgical Services Policy
	Urgent Care Policy
	Urodynamics Policy

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