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Providers
 
Guides and Codes

  • CPT® Surgery Guidelines Chart

  • Use this chart to determine the relative value units, if an assistant surgeon is allowed, if the multiple surgery guidelines apply, or if the surgery includes normal pre- and post-operative care for each surgical CPT code.

    The List of Investigative Treatments has been expanded and moved to be included in the Medical Policy Manual in the Library under Policies and Procedures.

    The HME Index is for Nebraska members only and some policies may have limitations. If an item displays an IC, this means the coverage is dependent on the member's contract and you will need to call to verify coverage. These items should also be preauthorized.

    The Ambulatory Procedure Codes listing has been discontinued. Please continue to provide surgical services in the most appropriate setting as stipulated in the Provider Agreement. For the definition of Medically Necessary or Medical Necessity, refer to the Glossary to the left.

    The Medical and Surgical Supplies Codes listing has been removed as these supplies are denied as content of service when used in the physician's office should remain without change.

    Fee schedules are not published online at this time, please contact your Health Network Consultant for more information.

    Electronic Remittance Remark Code Lists