Molina Healthcare Nebraska policy
Hydrolyzed Eternal Formula Diagnosis Policy
Hydrolyzed Eternal Formula Diagnosis Policy is a public Molina Healthcare Nebraska policy. It lists 30 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
- Line of business
- Medicaid
- States
- AZ, CA, FL, IA, MA, NE, NM, NV, NY
- Source
- www.molinahealthcare.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other Molina Healthcare Nebraska policies |
|---|---|
| 80047 | Policies naming 80047 |
| 80048 | Policies naming 80048 |
| 80051 | Policies naming 80051 |
| 80053 | Policies naming 80053 |
| 80069 | Policies naming 80069 |
| 80076 | Policies naming 80076 |
| 82306 | Policies naming 82306 |
| 82330 | Policies naming 82330 |
| 82575 | Policies naming 82575 |
| 83550 | Policies naming 83550 |
| 84466 | Policies naming 84466 |
| 84540 | Policies naming 84540 |
| 85046 | Policies naming 85046 |
| 87075 | Policies naming 87075 |
| 87081 | Policies naming 87081 |
| B4153 | Policies naming B4153 |
| B4161 | Policies naming B4161 |
| J0604 | Policies naming J0604 |
| J0606 | Policies naming J0606 |
| J0610 | Policies naming J0610 |
| J0882 | Policies naming J0882 |
| J0887 | Policies naming J0887 |
| J1200 | Policies naming J1200 |
| J1270 | Policies naming J1270 |
| J1756 | Policies naming J1756 |
| J1940 | Policies naming J1940 |
| J2501 | Policies naming J2501 |
| J2916 | Policies naming J2916 |
| Q0163 | Policies naming Q0163 |
| Q4081 | Policies naming Q4081 |