Part of our customer promise is helping you ensure that all testing is ordered and performed in accordance with quality and medical necessity guidelines. The links below provide access to listings compiled by Sunrise of all ICD-9-CM and ICD-10-CM codes included in limited coverage determinations that third party payers have put into effect.

Medical Necessity Checker Sunrise NY

Medical Necessity Checker Sunrise Chantilly


Medicare

Effective 1/1/2017:

Medicare Medical Review Policies (Code Listings for ICD-10)Medicare Medical Review Policies

Effective 1/1/2018:

Medicare Medical Review Policies (Code Listings for ICD-10-CM) Medicare Medical Review Policies

CMS National Coverage Determinations Medicare Medical Review Policies

 


Cigna

CIGNA Guidelines Medical Necessity Criteria for Vitamin D  Medicare Medical Review Policies 

Effective 3/15/18                                      

 


 

United Healthcare

Effective 06/01/2018:
Hepatitis Screening Medical Policy United Healthcare Medical Review Policies

 

* Embedded word files have been converted over to PDF for your convenience.

Hepatitis ICD10 Codes 

If you wish to read the complete Medicare NCDs and LCDs, including the explanatory text, you can click on the additional links listed below, which will take you to the applicable pages on the CMS and NGS web sites.

NGS Local Coverage Determinations

 


United Healthcare Community Plan

Effective 1/1/2017:

United Healthcare Community Plan RAST Policy (Code Listings)United Healthcare Community Plan Clinical Diagnostic Labs Policy (Code Listings)

*Embedded word files in the above document available below 

Effective 10/1/15

RAST ICD10 CodesUnited Healthcare Community Plan Clinical Diagnostic Labs Policy (Code Listings)

RAST ICD9 CodesUnited Healthcare Community Plan Clinical Diagnostic Labs Policy (Code Listings) 

Effective 1/1/2018:

United Healthcare Community Plan Clinical Diagnostic Labs Policy (Code Listings)United Healthcare Community Plan Clinical Diagnostic Labs Policy (Code Listings)

Effective 1/1/2017:

Hepatitis Screening PolicyUnited Healthcare Community Plan Clinical Diagnostic Labs Policy (Code Listings)

* Embedded word files have been converted over to PDF for your convenience.

Hepatitis ICD9 Codes United Healthcare Medical Review Policies

Hepatitis ICD10 Codes United Healthcare Medical Review Policies