Site Activity
This page provides a monthly listing of publication activity on the Medical Policy Portal including Policy Notifications, New Policies, Updated Policies, Coding Updates, Reissued Policies, and Archived Policies. To view publication activity from prior months, select Past Site Activity.

Past Site Activity
 
                                                                                        

Notifications
The following Independence Blue Cross Medicare Advantage policies have been posted prior to their effective date.
MA11.017e, Trigger Point Injections
Notification: 04/01/2019 | Effective: 04/01/2019 | Posted: 01/02/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

MA08.007n, Medicare Part B vs. Part D Crossover Drugs
Notification: 01/25/2019 | Effective: 02/25/2019 | Posted: 01/25/2019
Type of policy change: Medical Coding


New Policies
The following Medicare Advantage policies have been newly developed to communicate coverage and/or reimbursement positions, reporting requirements, and other processes and procedures for doing business with Independence Blue Cross.
MA12.003, Acute Care Facility Inpatient Transfers
Notification: 11/02/2018 | Effective: 01/01/2019 | Posted: 01/02/2019
Type of policy change: This is a new policy.

MA08.101, Canakinumab (Ilaris®)
Effective: 01/28/2019 | Posted: 01/28/2019
Type of policy change: This is a new policy.


Updated Policies
The following Medicare Advantage policies have been reviewed and updated to communicate current coverage and/or reimbursement positions, reporting requirements, and other procedures for doing business with Independence Blue Cross.
MA10.008c, Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)
Notification: 11/30/2018 | Effective: 01/01/2019 | Posted: 01/02/2019
Type of policy change: Coverage and/or Reimbursement Position

MA00.047b, Musculoskeletal Services
Notification: 10/16/2018 | Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA07.027b, Autonomic Nervous System Testing
Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA00.001a, Obsolete or Unreliable Diagnostic Tests and Medical Services
Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding

MA11.026d, Epidural, Paravertebral Facet, and Sacroiliac Joint Injections for Spinal Pain Management
Notification: 10/16/2018 | Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria

MA11.031g, Spinal Cord and Dorsal Root Ganglion Stimulation
Notification: 10/16/2018 | Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.029d, Spinal Discectomy
Notification: 10/16/2018 | Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: General Description, Guidelines, or Informational Update

MA11.041b, Spinal Laminectomy
Notification: 10/16/2018 | Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: General Description, Guidelines, or Informational Update

MA11.024d, Percutaneous Vertebroplasty and Percutaneous Vertebral Augmentation
Notification: 10/16/2018 | Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: General Description, Guidelines, or Informational Update

MA11.102f, Denervation of the Spinal Nerves for Chronic Pain
Notification: 10/16/2018 | Effective: 01/14/2019 (Revised 02/21/2019) | Posted: 01/14/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria

MA11.082c, Autologous Chondrocyte Implantation (ACI)/Carticel® and Other Cell-based Treatments of Focal Articular Cartilage Lesions
Notification: 10/16/2018 | Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.044d, Artificial Intervertebral Disc Insertion
Notification: 10/16/2018 | Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

MA11.081a, Meniscal Allograft Transplantation
Notification: 10/16/2018 | Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.108c, Spinal Fusion
Notification: 10/16/2018 | Effective: 01/14/2019 | Posted: 01/14/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA07.017c, Hyperthermic Intraperitoneal Chemotherapy for Select IntraAbdominal and Pelvic Malignancies
Effective: 01/21/2019 | Posted: 01/22/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA00.005q, Experimental/Investigational Services
Effective: 01/01/2019 | Posted: 01/22/2019
Type of policy change: Medical Coding

MA11.019d, Vagus Nerve Stimulation (VNS)
Effective: 01/21/2019 | Posted: 01/22/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA08.017c, Botulinum Toxin Agents
Effective: 01/28/2019 | Posted: 01/28/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA10.003e, Physical Medicine & Rehabilitation Services: Physical Therapy (PT) and Occupational Therapy (OT)
Notification: 12/28/2018 | Effective: 01/28/2019 | Posted: 01/28/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA08.011d, Erythropoiesis Stimulating Agents (ESAs)
Notification: 12/28/2018 | Effective: 01/28/2019 (Revised: 04/08/2019) | Posted: 01/28/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update


Coding Update
The following Medicare Advantage policies have been reviewed and updated to add new and revised medical codes (e.g., ICD-9 and ICD-10 diagnosis codes; CPT® and HCPCS codes; revenue codes) and/or remove terminated medical codes.
MA00.036d, Remote Patient Management: Telemedicine Services
Effective: 01/01/2019 | Posted: 01/02/2019

MA05.017b, Home Oxygen Therapy
Effective: 01/01/2019 | Posted: 01/02/2019

MA05.001c, High-Frequency Chest Wall Oscillation Devices
Effective: 01/01/2019 | Posted: 01/02/2019

MA05.035b, Cold Therapy Devices
Effective: 01/01/2019 | Posted: 01/02/2019

MA05.067a, Leadless Pacemakers
Effective: 01/01/2019 | Posted: 01/02/2019

MA05.047d, Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults
Effective: 01/01/2019 | Posted: 01/02/2019

MA07.026c, Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring
Effective: 01/01/2019 | Posted: 01/02/2019

MA07.038e, Neuropsychological Testing for Neurologically Based Conditions
Effective: 01/01/2019 (Revised 03/06/2019. 03/13/2019) | Posted: 01/02/2019

MA05.029b, Heating Pads and Heat Lamps
Effective: 01/01/2019 | Posted: 01/02/2019

MA05.020e, Therapeutic Shoes
Effective: 01/01/2019 | Posted: 01/02/2019

MA08.022f, Rituximab (Rituxan®) infusion, and rituximab and hyaluronidase human (Rituxan Hycela™) for subcutaneous injection
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.072c, Bevacizumab (Avastin®) and related biosimilars
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.010j, Programmed Death Receptor-1 (PD-1) Antagonists (e.g., Keytruda®, Opdivo®) and Programmed Death-Ligand 1 (PD-L1) Antagonists (e.g., Tecentriq®, Bavencio®, Imfinzi™)
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.034C, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase™, Vimizim™, Naglazyme®, Mepsevii™, etc.)
Effective: 01/01/2019 | Posted: 01/03/2019

MA07.055b, Allergy Immunotherapy
Effective: 01/01/2018 | Posted: 01/03/2019

MA08.007m, Medicare Part B vs. Part D Crossover Drugs
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.089b, Cerliponase alfa (Brineura™)
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.037e, Bortezomib (Bortezomib for Injection, Velcade®)
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.019e, Infliximab and Related Biosimilars
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.024e, Interleukin-5 (IL-5) Antagonist (e.g., Cinqair®, Nucala®) and IL-5 Receptor Antagonist (e.g., Fasenra™)
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.100a, Patisiran (Onpattro™)
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.092a, Edaravone (Radicava™)
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.091b, Aprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®)
Effective: 01/01/2019 (Revised 01/09/2019) | Posted: 01/03/2019

MA08.094c, Voretigene Neparvovec-rzyl (Luxturna™)
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.097a, Triamcinolone Acetonide Extended-Release Injectable (Zilretta™)
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.093d, Chimeric Antigen Receptor (CAR) Therapy
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.098a, Tildrakizumab-asmn (Ilumya™)
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.099a, Burosumab-twza (Crysvita®)
Effective: 01/01/2019 | Posted: 01/03/2019

MA08.096a, ibalizumab-uiyk (Trogarzo™)
Effective: 01/01/2019 | Posted: 01/03/2019

MA09.002h, High-Technology Radiology Services
Effective: 01/02/2019 | Posted: 01/03/2019

MA11.001g, Treatment of Varicose Veins of the Lower Extremities and Perforator Vein Incompetence
Effective: 01/01/2019 | Posted: 01/03/2019

MA11.011c, Artificial Hearts and Ventricular Assist Devices (VADs)
Effective: 01/01/2019 | Posted: 01/03/2019

MA10.007b, Speech Therapy
Effective: 01/01/2019 | Posted: 01/03/2019

MA11.005c, Deep Brain Stimulation (DBS)
Effective: 01/01/2019 | Posted: 01/03/2019

MA09.020g, Radiation Therapy Services
Effective: 01/01/2019 | Posted: 01/03/2019

MA11.068c, Sentinel Lymph Node Biopsy
Effective: 01/01/2019 | Posted: 01/03/2019

MA11.023h, Hyaluronan Acid Therapies for Osteoarthritis of the Knee
Effective: 01/01/2019 | Posted: 01/03/2019

MA11.015g, Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds
Effective: 01/01/2019 | Posted: 01/03/2019

MA11.028e, Sacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for the Control of Incontinence
Effective: 01/01/2019 | Posted: 01/03/2019

MA11.107b, Implantable Steroid-Eluting Sinus Stents
Effective: 01/01/2019 | Posted: 01/03/2019

MA05.028d, Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum
Effective: 01/01/2019 | Posted: 01/04/2019

MA00.019e, Radiologic Guidance of a Procedure
Effective: 01/01/2019 | Posted: 01/04/2019

MA05.044f, Durable Medical Equipment (DME)
Effective: 01/01/2019 | Posted: 01/04/2019

MA01.005c, Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services
Effective: 01/01/2019 | Posted: 01/04/2019

MA06.010b, Genetic Testing for Inherited Breast Cancer 1 (BRCA1) and Breast Cancer 2 (BRCA2) Mutations
Effective: 01/01/2019 | Posted: 01/04/2019

MA06.023c, Nerve Fiber Density Testing
Effective: 01/01/2019 | Posted: 01/04/2019

MA06.022e, Biomarkers for Oncology
Effective: 01/01/2019 | Posted: 01/04/2019

MA00.037f, Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
Effective: 01/01/2019 | Posted: 01/04/2019

MA06.024a, Noninvasive Techniques for the Evaluation and Monitoring of Individuals with Chronic Liver Disease
Effective: 01/01/2019 | Posted: 01/04/2019

MA06.025h, Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
Effective: 01/01/2019 | Posted: 01/04/2019

MA00.006e, Care Management and Care Planning Services
Effective: 01/01/2019 | Posted: 01/04/2019

MA06.017o, Molecular Diagnostics
Effective: 01/01/2019 | Posted: 01/04/2019

MA11.037d, Use of an Operating Microscope During a Surgical Procedure
Effective: 01/01/2019 | Posted: 01/11/2019

MA00.026e, Always Bundled Procedure Codes
Effective: 01/01/2019 | Posted: 01/16/2019

MA00.010t, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Effective: 01/01/2019 | Posted: 01/29/2019


Archived Policies
Independence Blue Cross has determined that it is no longer necessary for the following Medicare Advantage policy to remain active.
MA00.018b, Prolonged Face-to-Face Physician Services
Notification: 01/02/2019 | Archive Effective: 02/04/2019 | Posted: 01/02/2019










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