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Governing Rules
Health Service Codes
Modifiers
Explanatory Codes
Governing Rules
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1
DEFINITIONS
2
APPLICATIONS
3
EXCLUSIONS
4
VISITS AND CONSULTATIONS
5
EMERGENCY/URGENT/CRITICAL CARE
6
PROCEDURES
7
RECONSTRUCTIVE PLASTIC SURGERY
8
OBSTETRICS AND GYNECOLOGY
9
OPHTHALMOLOGY
10
DENTAL/ORAL SURGICAL RELATED SERVICES
11
LABORATORY/PATHOLOGY/RADIOLOGY
12
ANESTHESIA
13
SURGICAL ASSISTANCE BENEFITS
14
TRAY SERVICE
15
OFF HOURS PREMIUM BENEFITS
15.1
15.2
Deleted
15.3
UNSCHEDULED SERVICES/SPECIAL CALLBACKS - AACC, UCC, HOSPITAL INPATIENT, OUTPATIENT AND EMERGENCY DEPARTMENTS
15.4
15.5
15.6
15.7
Claims for Unscheduled Services/Special Callback Benefits
15.8
15.9
15.10
15.11
MAXIMUMS FOR SPECIAL CALLBACKS
15.12
Deleted
15.13
AFTER HOURS TIME PREMIUM - HOSPITAL INPATIENT, OUTPATIENT AND EMERGENCY
16
Deleted
17
TELEHEALTH
18
BODY MASS INDEX (BMI)
19
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Governing Rule: 15.2
Deleted
Health Service Codes
HSCs
Modifiers
Explanatory Codes
Exp. Codes
Governing Rules
Gov. Rules
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