2025 March Medical Policy Updates

DEADLINE: By March 31, 2025 — Billing team must complete the following tasks: (1) Update billing software to add 45 newly covered procedure codes effective 04/01/2025: CPT codes 83700, 83701, 83704, 83718, 83719, 83721, 83722, 83880 (cardiovascular risk assessment); HCPCS code A2035 and Q4346-Q4367 (amniotic membrane injections); L5827 (microprocessor prosthetic); E1832 (stretching device); and unlisted procedure codes 0531U, 0308U, 0309U, 0541U, 0534U, 0550U, 0532U, 0549U, 0288U, 0547U, 0548U, 0551U, 0536U. (2) Remove archived policies CAM 012 (SPECT/CT Fusion Imaging) and CAM 80101 (Adoptive Immunotherapy) from billing system and inform providers these services are no longer covered. (3) Update anesthesia billing rules in system: revise policy language to state qualifying circumstances will only be paid when physician (modifier AA) or unsupervised CRNA (modifier QZ) administers anesthesia personally—remove any existing rule that blanket denies separate reimbursement for qualifying circumstances. (4) Verify encounter forms and prior authorization templates reflect the new anesthesia supervision requirements. Claims submitted after 04/01/2025 using archived service codes or old anesthesia payment rules will be denied or require rebilling.