Active Notifications
The notifications listed below represent new policy versions that are scheduled to become active on the intended Policy Effective Date. These notifications allow you to become familiar with the new policy version in advance of its release. Please check back frequently as notifications are posted often.

Note: The documents below are strictly notifications of future policy updates. The positions and criteria addressed in the notification are not enforced until the Policy Effective Date. To view current company policies, go to the Policy Bulletins section of this site or click here.



Policy Effective Date
Notification Title
Notification Issue Date
Hide details for 04/01/202004/01/2020
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Electrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds
12/30/2019
Attachment A (ICD-10 Codes) to 07.07.07g Electrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds
Hide details for 04/15/202004/15/2020
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Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
01/15/2020
Attachment A to 00.10.39l Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
Consultation Services
01/15/2020
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Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
12/31/2019
Attachment A (E&M codes appended with modifier 25 should be reimbursed at 50% of the applicable fee schedule amount when submitted on the same date of service, by the same professional provider or other qualified health care provider, as a minor procedure.) to 03.00.06r Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
Attachment B (Problem-focused E&M Codes appended with modifier 25 should be reimbursed at 50% of the applicable fee schedule amount when submitted on the same date of service by the same professional provider or other qualified health care provider, as a preventive E&M.) to 03.00.06r Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
Preoperative Consultations Performed by Providers in Anesthesia Specialties
01/03/2020
Hide details for 04/20/202004/20/2020
Autologous Blood Services (Collection, Storage, Transfusion, and Perioperative Salvage)
03/20/2020
Cranial Remolding Orthoses (Helmets)
03/20/2020
Hide details for 04/21/202004/21/2020
Anesthesia Services for a Cancelled or Discontinued Procedure
01/22/2020
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Reporting and Documentation Requirements for Anesthesia Services
01/22/2020
Attachment A (ASA Anesthesia Procedure Codes) to 00.01.14r Reporting and Documentation Requirements for Anesthesia Services
Hide details for 05/15/202005/15/2020
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Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use
02/13/2020
Attachment A (Dosing and Frequency Requirements) to 08.00.66n Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use
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Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®)
02/13/2020
Attachment A (Dosing and Frequency Requirements For Rituximab (Rituxan®) infusion and related biosimilars, and rituximab/hyaluronidase human for subcutaneous injection (Rituxan Hycela®)) to 08.00.50u Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®)
Attachment B (ICD-10 CODES AND NARRATIVES) to 08.00.50u Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®)
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Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)
02/13/2020
Attachment A (Dosing & Frequency Requirements for Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and hyaluronidase-oysk (Herceptin Hylecta)) to 08.00.33o Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)
Attachment B (ICD-10 CM Codes and Narratives) to 08.00.33o Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)
Hide details for 05/17/202005/17/2020
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High-Technology Radiology Services (Independence)
02/17/2020
Attachment A (High-Technology Radiology Services Code List ) to 09.00.46aa High-Technology Radiology Services (Independence)
Hide details for 05/18/202005/18/2020
Chiropractic Spinal and Extraspinal Manipulation Therapy
02/18/2020
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PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
02/14/2020
Attachment A1 (DME Network Rules and Limited Circumstances) to 00.01.25aw PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Attachment A2 (DME Network Rules and Limited Circumstances cont'd.) to 00.01.25aw PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Attachment A3 (DME Network Rules and Limited Circumstances) to 00.01.25aw PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Attachment B1 (Laboratory Network Rules and Limited Circumstances) to 00.01.25aw PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Attachment B2 (Laboratory Network Rules and Limited Circumstances cont'd.) to 00.01.25aw PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Attachment B3 (Laboratory Network Rules and Limited Circumstances cont'd.) to 00.01.25aw PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Attachment C1 (Radiology Network Rules and Limited Circumstances) to 00.01.25aw PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Attachment C2 (Radiology Network Rules and Limited Circumstances cont'd.) to 00.01.25aw PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Attachment D (Physical Medicine & Rehabilitation Network Rules and Limited Circumstances) to 00.01.25aw PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Hide details for 06/15/202006/15/2020
Artificial Intervertebral Disc Insertion
03/11/2020
Denervation of the Spinal Nerves for Chronic Pain
03/11/2020
Epidural, Paravertebral Facet, and Sacroiliac Joint Injections for Spinal Pain Management
03/11/2020
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Meniscal Allograft Transplantation and Meniscal Implants
03/11/2020
Attachment A (ICD-10-CM codes) to 11.14.03g Meniscal Allograft Transplantation and Meniscal Implants
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Musculoskeletal Services (Independence)
03/11/2020
Attachment A (Procedure Codes for Spinal Surgery) to 00.01.66c Musculoskeletal Services (Independence)
Attachment B (Procedure Codes for Joint Surgery) to 00.01.66c Musculoskeletal Services (Independence)
Attachment C (Procedures Codes for Interventional Pain Management) to 00.01.66c Musculoskeletal Services (Independence)
Spinal Cord and Dorsal Root Ganglion Stimulation
03/11/2020
Spinal Discectomy
03/11/2020
Spinal Fusion
03/11/2020
Spinal Laminectomy
03/11/2020

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