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A tough new policy for trigger point injections (20552-20553) will soon hit 38 states. Practices that don’t prepare will trigger denials that can’t be cured with an appeal.
 
 
As flu season continues, stay up to date on the current national, non-facility pricing of influenza vaccines. The table below conveys 2023-2024 payment allowances on oft-reported vaccines, along with coding details. Also, don't forget to add an M code when performing in-home vaccinations.
 
 
The CDC recently released tabular addenda changes to the ICD-10 code set, effective April 1. Among the changes are revisions to the “Excludes 2” note found under J45 (Asthma).
 
 
CMS reverses course and creates frequency limits for prolonged service codes G0316-G0318.
 
CMS has not released a final national coverage determination (NCD) for pre-exposure prophylaxis (PrEP) to prevent human immunodeficiency virus (HIV). And CMS did not discuss the service in the physician fee schedule final rule. But practices and clinics can find previews of the service in the 2024 HCPCS update, the relative value units (RVU) file for the 2024 Medicare and appendix B of proposed decision memo CAG-00464N.

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