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.
MA09.009f, Diagnostic and Therapeutic Radiopharmaceutical Agents
Notification: 10/03/2016 | Reissue Effective: N/A | Reissue Posted: 10/03/2016

MA05.016a, Home Prothrombin Time Monitoring
Notification: 10/05/2016 | Effective: 11/04/2016 | Posted: 10/05/2016
Type of policy change: Medical Coding

MA05.010b, Ankle-Foot/Knee-Ankle-Foot Orthoses
Notification: 10/20/2016 | Effective: 11/18/2016 | Posted: 10/20/2016
Type of policy change: General Description, Guidelines, or Informational Update

MA11.023d, Hyaluronan Acid Therapies for Osteoarthritis of the Knee
Notification: 10/28/2016 | Effective: 11/28/2016 | Posted: 10/28/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update


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.
MA00.011b, Modifier 62: Two Surgeons
Effective: 10/01/2016 | Posted: 10/03/2016

MA07.013c, Electrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds
Effective: 10/12/2016 | Posted: 10/12/2016
Type of policy change: Medical Coding

MA10.003a, Physical Medicine & Rehabilitation Services: Physical Therapy (PT) and Occupational Therapy (OT)
Notification: 07/14/2016 | Effective: 10/12/2016 | Posted: 10/12/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA05.054b, Urological Supplies
Notification: 09/14/2016 | Effective: 10/14/2016 | Posted: 10/14/2016
Type of policy change: Medical Coding

MA07.036b, Low-Level Laser Therapy
Notification: 09/14/2016 | Effective: 10/14/2016 | Posted: 10/14/2016

MA07.058d, Sleep Disorder Testing and Positive Airway Pressure Therapy
Notification: 09/14/2016 | Effective: 10/14/2016 | Posted: 10/14/2016
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.043b, Pralatrexate (Folotyn®) for Injection
Effective: 10/19/2016 | Posted: 10/19/2016
Type of policy change: Medical Necessity Criteria; Medical Coding

MA08.049b, Paclitaxel Protein-bound Particles for Injectable Suspension (Albumin-bound)/(Abraxane® for Injectable Suspension)
Effective: 10/19/2016 | Posted: 10/19/2016
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA00.004a, Routine Costs of Clinical Trials and Coverage of Investigational Devices A and B
Effective: 10/28/2016 | Posted: 10/28/2016
Type of policy change: Medical Necessity Criteria; Medical Coding


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA10.002a, Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs
Reissue Effective: 10/12/2016 | Reissue Posted: 10/13/2016

MA05.035a, Cold Therapy Devices
Reissue Effective: 10/26/2016 | Reissue Posted: 10/27/2016

MA05.036, Commodes
Reissue Effective: 10/26/2016 | Reissue Posted: 10/27/2016

MA05.050, Eye Prostheses
Reissue Effective: 10/26/2016 | Reissue Posted: 10/27/2016

MA08.064, Omacetaxine Mepesuccinate (Synribo®)
Reissue Effective: 10/26/2016 | Reissue Posted: 10/27/2016

MA08.026a, Complex Regional Pain Syndrome (CRPS) Parenteral Treatments
Reissue Effective: 10/28/2016 | Reissue Posted: 10/28/2016

MA08.051c, C1 Esterase Inhibitors: Cinryze®, Berinert®, and Ruconest®
Reissue Effective: 10/26/2016 | Reissue Posted: 10/28/2016


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.
MA11.016a, Prostate Mapping Biopsy
Effective: 10/01/2016 | Posted: 10/01/2016

MA11.029a, Spinal Discectomy
Effective: 10/01/2016 | Posted: 10/01/2016

MA06.007b, Loss-of-Heterozygosity-Based Topographic Genotyping with PathFinderTG®
Effective: 10/01/2016 | Posted: 10/01/2016

MA06.017e, Molecular Diagnostics
Effective: 10/01/2016 | Posted: 10/01/2016

MA06.022b, Biomarkers for Oncology
Effective: 10/01/2016 | Posted: 10/01/2016

MA11.012a, Endovascular Grafts for Abdominal Aortic Aneurysms, Aortic-Iliac Aneurysms, and Infrarenal Aortic Aneurysms
Effective: 10/01/2016 | Posted: 10/01/2016

MA07.024a, Medical and Surgical Treatment of Temporomandibular Joint Disorder
Effective: 10/01/2016 | Posted: 10/01/2016

MA07.046c, Corneal Pachymetry Using Ultrasound
Effective: 10/01/2016 | Posted: 10/01/2016

MA11.004d, Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)
Effective: 10/01/2016 | Posted: 10/01/2016

MA11.067b, Labiaplasty
Effective: 10/01/2016 | Posted: 10/01/2016

MA11.017b, Trigger Point Injections
Effective: 10/01/2016 | Posted: 10/01/2016

MA11.076c, Removal of Breast Implants
Effective: 10/01/2016 | Posted: 10/01/2016

MA11.044b, Artificial Intervertebral Disc Insertion
Effective: 10/01/2016 | Posted: 10/01/2016

MA00.027d, Diagnostic Radiology Services Included in Capitation
Effective: 10/01/2016 | Posted: 10/03/2016

MA00.029c, Physical Medicine and Rehabilitation Services Eligible for Reimbursement Above Capitation to Physical and Occupational Therapy (PT/OT) Providers for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
Effective: 10/01/2016 | Posted: 10/03/2016

MA11.105b, Aqueous Shunts, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma
Effective: 10/01/2016 | Posted: 10/03/2016

MA11.109a, Procedures for the Treatment of Acne
Effective: 10/01/2016 | Posted: 10/03/2016

MA00.010i, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Effective: 10/01/2016 | Posted: 10/03/2016

MA11.106a, Sex Reassignment Surgery (SRS) for Gender Identity Disorder (GID)
Effective: 10/01/2016 | Posted: 10/14/2016










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