Florida Blue policy

Unbundled, Incidental, and Mutually Exclusive Services

Unbundled, Incidental, and Mutually Exclusive Services is a public Florida Blue policy (policy 18-063). It lists 65 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer
Florida Blue
Policy number
18-063
Line of business
Commercial, Medicaid
Source
files.guidewell.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes.

CodeOther Florida Blue policies
22630Policies naming 22630
22632Policies naming 22632
22633Policies naming 22633
22634Policies naming 22634
29822Policies naming 29822
29823Policies naming 29823
29824Policies naming 29824
29827Policies naming 29827
29828Policies naming 29828
29862Policies naming 29862
29863Policies naming 29863
29914Policies naming 29914
29916Policies naming 29916
36000Policies naming 36000
36591Policies naming 36591
36592Policies naming 36592
44150Policies naming 44150
45100Policies naming 45100
46600Policies naming 46600
46606Policies naming 46606
49000Policies naming 49000
58260Policies naming 58260
58262Policies naming 58262
58720Policies naming 58720
63047Policies naming 63047
63048Policies naming 63048
63056Policies naming 63056
63057Policies naming 63057
76376Policies naming 76376
76377Policies naming 76377
77065Policies naming 77065
77066Policies naming 77066
80050Policies naming 80050
94760Policies naming 94760
97802Policies naming 97802
97803Policies naming 97803
99173Policies naming 99173
99201Policies naming 99201
99202Policies naming 99202
99205Policies naming 99205
99211Policies naming 99211
99215Policies naming 99215
99381Policies naming 99381
99397Policies naming 99397
99401Policies naming 99401
99404Policies naming 99404
99459Policies naming 99459
A4206Policies naming A4206
A4207Policies naming A4207
A4208Policies naming A4208
A4209Policies naming A4209
A4210Policies naming A4210
A4213Policies naming A4213
A4215Policies naming A4215
A4221Policies naming A4221
A4222Policies naming A4222
A4556Policies naming A4556
A4617Policies naming A4617
A6448Policies naming A6448
G0101Policies naming G0101
G0270Policies naming G0270
Q0091Policies naming Q0091
S2900Policies naming S2900
S9083Policies naming S9083
S9088Policies naming S9088

All Florida Blue policies

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.