Folate testing policy update

Effective December 1, 2020, Healthfirst will no longer reimburse for folate testing (82746) when performed more than once per year, with the exception of deficiency disorder or malabsorption syndrome, testing for which will be allowable four times per year.

Treatment of Benign Hyperkeratotic Lesions

Effective December 1, 2020, Healthfirst will no longer reimburse for the paring of hyperkeratotic lesions (11055–11057) for the treatment of hyperkeratosis without an additional diagnosis such as the metabolic, neurologic, or peripheral vascular disease on the claim.

According to CMS policy, the paring of hyperkeratotic lesions (11055–11057) for the treatment of hyperkeratosis also requires an additional diagnosis to indicate that a complication such as pain or infection exists or that severe systemic disease exists that has resulted in circulatory or neurologic impairment.

Nail Plate Avulsion Therapy

Effective December 1, 2020, Healthfirst will no longer reimburse for the avulsion of nail plate partial or complete, simple (11730, 11732) when billed more than once in a 12-week period.

Radiological Examination Chest