Current Policies

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A

• Air Ambulance Transportation

B

• Breathalyzer Testing

C

• COVID-19 Testing
• COVID-19 Vaccine and Administration
• Codes Billed with Revenue Codes 510 through 519

D

• Diagnosis Related Groups (DRG) Validation

E

• Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

G

• Gold Card Program

H

• Hospital Readmission Occurring within 30 Days of an Index Admission

M

• Modifier TC (Technical), 26 (Professional)
• Modifier 76, 77 (Repeat Procedures)
• Modifier 54, 55 (Split Care: Surgical Care and Postoperative Management)
• Modifier 22, 63 (Increased Services)
• Modifier 53,73 (Discontinued Procedures)
• Modifier 24 (Unrelated Evaluation and Management (E/M) Service)
• Modifier 90, 91 (Laboratory Services)
• Modifier AS, 80, 81, 82 (Assistant at Surgery)
• Modifier KD (Durable Medical Equipment Drug Administration)
• Modifier 78 (Unplanned Return to Procedure Room)
• Modifier 62, 66 (Multiple Surgeons)
• Modifier 50 (Bilateral Procedure)

N

• Never Events, Adverse Events, Hospital Acquired Conditions, Serious Reportable Conditions & Provider Preventable Conditions  
• Non-Covered / Non-Reimbursable Codes

O

• Outpatient Hospital Laboratory Pass Through Billing 

P

• Prepayment Review Process - Mountain Health Trust (Medicaid & CHIP)

R

• Robot Assisted Surgery

U

• Urine Drug Screening (UDS) via Telehealth

W

• Women's Health Services - Pregnancy Termination Services