PrimeWest Health policy
Medical, Dental & Pharmacy > Medical > Equipment and Supplies > Non-Covered Services
Medical, Dental & Pharmacy > Medical > Equipment and Supplies > Non-Covered Services is a public PrimeWest Health policy (policy PW_11-19_539, effective Sep 8, 2025). It lists 1 CPT or HCPCS code. Not a coverage decision; the payer's own document governs.
- Payer
- PrimeWest Health
- Policy number
- PW_11-19_539
- Effective
- Sep 8, 2025
- Line of business
- Medicaid
- States
- MN
- Source
- www.primewest.org
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other PrimeWest Health policies |
|---|---|
| A9270 | Policies naming A9270 |