Medica policy
Add-On Code
Add-On Code is a public Medica policy (policy RP-P-100X, effective Oct 30, 2006). It lists 14 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
- Payer
- Medica
- Policy number
- RP-P-100X
- Effective
- Oct 30, 2006
- Line of business
- Commercial, Medicaid
- Source
- partner.medica.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other Medica policies |
|---|---|
| 01968 | Policies naming 01968 |
| 01969 | Policies naming 01969 |
| 17311 | Policies naming 17311 |
| 17312 | Policies naming 17312 |
| 17313 | Policies naming 17313 |
| 17314 | Policies naming 17314 |
| 17315 | Policies naming 17315 |
| 99100 | Policies naming 99100 |
| 99140 | Policies naming 99140 |
| 99291 | Policies naming 99291 |
| 99292 | Policies naming 99292 |
| 99359 | Policies naming 99359 |
| 99417 | Policies naming 99417 |
| 99418 | Policies naming 99418 |