| Clinical Trials and Rare Disease Policy | Commercial, Medicaid | 9 | Original policy ↗ |
| CMS Replacement Codes | Commercial, Medicaid | — | Original policy ↗ |
| Co Surgeon Team Surgeon Professional | Commercial, Medicaid | 2 | Original policy ↗ |
| Colonoscopy and Sigmoidoscopy | Commercial | 35 | Original policy ↗ |
| Condition Codes 49, 50, and 53 | Commercial, Medicaid | — | Original policy ↗ |
| Cooled Radiofrequency Ablation (CRFA) for the Management of Chronic Pain | 386 · Commercial, Medicaid | 7 | Original policy ↗ |
| Corneal Collagen Cross-Linking (CXL) | 328 · Effective Aug 12, 2026 · Commercial, Medicaid | 3 | Original policy ↗ |
| Corrected Claims | Commercial | — | Original policy ↗ |
| Cranial Orthotic Devices | Commercial | 3 | Original policy ↗ |
| Critical Care Codes when Discharging Home from the Emergency Department | Commercial | 2 | Original policy ↗ |
| Critical Care Codes when Discharging Home from the Emergency Department | Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI | 2 | Original policy ↗ |
| Cross-Departmental Recovery Policy | Medicaid | — | Original policy ↗ |
| CT Computed Tomography of the Abdomen and Pelvis | Commercial | — | Original policy ↗ |
| D M E Place of Service 31 or 32 | Effective Aug 6, 2025 · Medicaid | — | Original policy ↗ |
| D R G (DRG) Clinical Validation | Effective Aug 1, 2025 · Commercial, Medicaid | — | Original policy ↗ |
| D R G (DRG) Clinical Validation | Effective Aug 1, 2025 · Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI | — | Original policy ↗ |
| Decision for Surgery Modifier 57 | Commercial, Medicaid | — | Original policy ↗ |
| Decision for Surgery Modifier 57 | Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI | — | Original policy ↗ |
| Developmental Testing | Commercial, Medicaid | 3 | Original policy ↗ |
| Diagnosis Code Coding | Commercial, Medicaid | — | Original policy ↗ |
| Diagnosis Code Coding | Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, UT, WA, WI | — | Original policy ↗ |
| Diagnosis Code Y65 XX | Commercial, Medicaid | — | Original policy ↗ |
| Discontinued Procedures | Effective Aug 4, 2025 · Commercial, Medicaid | 4 | Original policy ↗ |
| DME Non Invasive Ventilator Settings | Commercial, Medicaid | 6 | Original policy ↗ |
| DME Place of Service Separately Reimbursable | Commercial, Medicaid | 9 | Original policy ↗ |
| DME Rental Vs Purchase | Commercial | 629 | Original policy ↗ |
| Donor Lymphocyte Infusion and Hematopoietic Stem Cell Boosts | Commercial, Medicaid | 3 | Original policy ↗ |
| Duplicate Claims | Effective Aug 19, 2025 · Commercial, Medicaid | — | Original policy ↗ |
| Duplicate Claims | Effective Aug 19, 2025 · Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NY, OH, SC, TX, WA, WI | — | Original policy ↗ |
| Durable Medical Equipment K F (KF)F Modifier | Commercial, Medicaid | 14 | Original policy ↗ |
| Durable Medical Equipment K F (KF)F Modifier | Medicaid · AZ, CA, FL, IA, ID, IL, MA, MI, NE, NM, NY, OH, SC, TX, WI | 14 | Original policy ↗ |
| Dynamic Exoskeletal Orthoses for Lower Extremity Injuries | Commercial, Medicaid | 3 | Original policy ↗ |
| Electric Tumor Treatment Fields for Glioblastoma | 353 · Commercial, Medicaid | 3 | Original policy ↗ |
| Electrocardiographic EKG or ECG Monitoring Holter or Real Time Monitoring | Commercial, Medicaid | — | Original policy ↗ |
| Electrostimulation and Electromagnetic Therapy for Wound Care | 399 · Effective Aug 12, 2026 · Commercial, Medicaid | 6 | Original policy ↗ |
| Elevidys (delandistrogene moxeparvovec-rokl) | Commercial, Medicaid | 3 | Original policy ↗ |
| Emergency Service E&M Codes and Place of Service 23 | Commercial | 5 | Original policy ↗ |
| Encelto (revakinagene tororetcel) | Commercial | 2 | Original policy ↗ |
| Enclosed Bed Systems | 329 · Commercial, Medicaid | 5 | Original policy ↗ |
| End Stage Renal Disease (ESRD) Consolidated Billing Policy | Effective Aug 4, 2025 · Commercial, Medicaid | 29 | Original policy ↗ |
| Enteral Nutrition | Commercial, Medicaid | 28 | Original policy ↗ |
| EPAP for Obstructive Sleep Apnea | Commercial, Medicaid | 2 | Original policy ↗ |
| Epidural Steroid Injections For Pain Management | Commercial, Medicaid | 7 | Original policy ↗ |
| ESRD 90999 No Modifier Weekly and Monthly Limits | Commercial, Medicaid | 1 | Original policy ↗ |
| ESRD Billing for J0406 or J0606 with Modifier AX | Commercial, Medicaid | 3 | Original policy ↗ |
| Evaluation of New Technology | Commercial, Medicaid | — | Original policy ↗ |
| Excludes 1 Note | | — | Original policy ↗ |
| Experimental and Investigational Services | Commercial, Medicaid | — | Original policy ↗ |
| Facility Bilateral or Anatomical Modifier Use | Commercial | — | Original policy ↗ |
| Facility Bilateral or Anatomical Modifier Use | Medicaid · AZ, CA, FL, IA, ID, IL, MA, NE, NM, NY, OH, SC, TX, UT, WA, WI | — | Original policy ↗ |
