Billing and Coding Article Updates for May and June 2023

Self-Administered Drug Exclusion List: Medical Policy Article A53021 (JK) and A53022 (J6)

The article has been updated to add: Adalimumab-aacf (Idacio®), Adalimumab-afzb (Abrilada™), Adalimumab-bwwd (Hadlima), Adalimumab-fkjp (Hulio®), Adalimumab-adaz (Hyrimoz), Adalimumab-aqvh (Yusimry) (C9399, J3490, J3590) effective for dates of service on or after 7/1/2023.

Billing and Coding: Urodynamics A57455

CPT code 55899 has been added to the CPT/HCPCS Codes section, Group 1.

The following language has been added to the Article Text section and to the Group 1 paragraph of the CPT/HCPCS Code section: “If a penile pressure cuff is used when providing a voiding pressure study, CPT Code 55899 should be reported with non-invasive urodynamic studies noted in the narrative portion of the claim.

The following language was added to the CPT/HCPCS Code section- Group 1 paragraph “CPT Code 55899 should only be used if a penile pressure cuff is used when providing a voiding pressure study.”

Posted 5/24/2023