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.
MA00.009f, Reporting and Documentation Requirements for Anesthesia Services
Notification: 10/01/2018 | Effective: 01/01/2019 | Posted: 10/01/2018

MA08.003d, Enteral Nutritional Therapy
Notification: 10/01/2018 (Revised 12/19/2018) | Effective: 01/01/2019 | Posted: 10/01/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.060c, Pegloticase (Krystexxa®)
Notification: 10/01/2018 | Effective: 01/01/2019 | Posted: 10/01/2018
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

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

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

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

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: 10/16/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

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

MA11.041b, Spinal Laminectomy
Notification: 10/16/2018 | Effective: 01/14/2019 | Posted: 10/16/2018
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 | Posted: 10/16/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria

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

MA00.047b, Musculoskeletal Services
Notification: 10/16/2018 (Revised 01/10/2019) | Effective: 01/14/2019 | Posted: 10/16/2018
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.
MA00.005p, Experimental/Investigational Services
Effective: 10/01/2018 | Posted: 10/01/2018
Type of policy change: Medical Coding

MA09.020f, Radiation Therapy Services
Notification: 06/29/2018 | Effective: 10/01/2018 | Posted: 10/01/2018
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

MA08.007l, Medicare Part B vs. Part D Crossover Drugs
Effective: 10/08/2018 | Posted: 10/08/2018
Type of policy change: Coverage and/or Reimbursement Position

MA08.058c, Blinatumomab (Blincyto®)
Notification: 07/10/2018 | Effective: 10/08/2018 | Posted: 10/08/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.009f, Immune Globulin: Intravenous (IVIG), Subcutaneous (SCIG)
Effective: 10/22/2018 | Posted: 10/22/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.105e, Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma
Notification: 07/25/2018 | Effective: 10/22/2018 | Posted: 10/22/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA09.002g, High-Technology Radiology Services
Notification: 08/01/2018 | Effective: 10/29/2018 | Posted: 10/29/2018
Type of policy change: General Description, Guidelines, or Informational Update

MA09.021c, Magnetic Resonance Imaging (MRI)--Guided Focused Ultrasound Ablation
Effective: 10/29/2018 | Posted: 10/29/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA11.090, Surgical Treatment of Femoroacetabular Impingement
Reissue Effective: 10/10/2018 | Reissue Posted: 10/12/2018

MA07.008a, Platelet-Rich Plasma (PRPs) for Chronic Non-Healing Wounds and Stem-Cell Therapy for Orthopedic Applications
Reissue Effective: 10/12/2018 | Reissue Posted: 10/12/2018

MA09.012a, Full-Body Computerized Tomography (CT) Scan Screening
Reissue Effective: 10/12/2018 | Reissue Posted: 10/12/2018

MA11.018c, Mohs' Micrographic Surgery (MMS)
Reissue Effective: 10/12/2018 | Reissue Posted: 10/12/2018

MA08.055d, Histone Deacetylase Inhibitors for Peripheral T-cell Lymphoma (e.g., Istodax®, Beleodaq®)
Reissue Effective: 10/12/2018 | Reissue Posted: 10/12/2018

MA05.021a, Injectable Dermal Fillers
Reissue Effective: 10/12/2018 | Reissue Posted: 10/12/2018

MA11.084b, Osteochondral Autograft Transplantation Procedure
Reissue Effective: 10/10/2018 | Reissue Posted: 10/15/2018

MA05.018a, Osteogenic Stimulators (i.e., Electrical Bone Growth Stimulation and Low-Intensity Ultrasound Accelerated Fracture Healing System)
Reissue Effective: 10/10/2018 | Reissue Posted: 10/15/2018

MA11.086b, Osteochondral Allograft Transplantation
Reissue Effective: 10/10/2018 | Reissue Posted: 10/15/2018

MA12.001c, Complementary and Integrative Health Services
Reissue Effective: 10/24/2018 | Reissue Posted: 10/25/2018

MA11.022a, Cryosurgical Ablation of the Prostate Gland
Reissue Effective: 10/24/2018 | Reissue Posted: 10/25/2018

MA00.024b, Reporting Requirements for Drugs and Biologics
Reissue Effective: 10/24/2018 | Reissue Posted: 10/25/2018

MA08.023a, Enzyme Replacement for the Treatment of Gaucher's Disease
Reissue Effective: 10/25/2018 | Reissue Posted: 10/25/2018

MA12.009, Cosmetic Procedures
Reissue Effective: 10/25/2018 | Reissue Posted: 10/25/2018

MA05.020d, Therapeutic Shoes
Reissue Effective: 10/25/2018 | Reissue Posted: 10/25/2018

MA05.012a, Orthopedic Footwear
Reissue Effective: 10/25/2018 | Reissue Posted: 10/25/2018


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.
MA05.001b, High-Frequency Chest Wall Oscillation Devices
Effective: 10/01/2018 | Posted: 10/01/2018

MA05.046d, Wheelchair Options and Accessories
Effective: 10/01/2018 | Posted: 10/01/2018

MA00.039c, Never Events and Preventable Adverse Events
Effective: 10/01/2018 | Posted: 10/01/2018

MA07.007e, Pulmonary Function Tests
Effective: 10/01/2018 | Posted: 10/01/2018

MA05.062d, Repair and Replacement of Durable Medical Equipment (DME)
Effective: 10/01/2018 | Posted: 10/01/2018

MA07.026b, Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring
Effective: 10/01/2018 | Posted: 10/01/2018

MA07.038d, Neuropsychological Testing for Neurologically Based Conditions
Effective: 10/01/2018 | Posted: 10/01/2018

MA07.033e, Nerve Conduction Studies (NCS) and Related Electrodiagnostic Studies
Effective: 10/01/2018 | Posted: 10/01/2018

MA07.047e, Pain Management of Peripheral Nerves by Injection
Effective: 10/01/2018 | Posted: 10/01/2018

MA07.050e, Electromyography (EMG) Studies: Needle EMG, Surface EMG (SEMG)
Effective: 10/01/2018 | Posted: 10/01/2018

MA11.002g, Hematopoietic Stem Cell Transplantation
Effective: 10/01/2018 | Posted: 10/01/2018

MA07.056c, Photodynamic Therapy (PDT) Using Levulan® Kerastick® (Aminolevulinic Acid HCl [ALA]) or Metvixia® (Methyl Aminolevulinate [MAL])
Effective: 10/01/2018 | Posted: 10/01/2018

MA08.059e, Ipilimumab (Yervoy®)
Effective: 10/01/2018 | Posted: 10/01/2018

MA08.077d, Talimogene laherparepvec (Imlygic™)
Effective: 10/01/2018 | Posted: 10/01/2018

MA10.004e, Chiropractic Services
Effective: 10/01/2018 | Posted: 10/01/2018

MA08.010i, 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: 10/01/2018 | Posted: 10/01/2018

MA07.060a, Oral and Maxillofacial Prosthesis
Effective: 10/01/2018 | Posted: 10/01/2018

MA08.017b, Botulinum Toxin Agents
Effective: 10/01/2018 | Posted: 10/01/2018

MA08.049d, Paclitaxel Protein-bound Particles for Injectable Suspension (Albumin-bound)/(Abraxane® for Injectable Suspension)
Effective: 10/01/2018 | Posted: 10/01/2018

MA11.073c, Panniculectomy, Abdominoplasty, Abdominal Lipectomy, and Other Excisions of Redundant Skin
Effective: 10/01/2018 | Posted: 10/01/2018

MA11.018c, Mohs' Micrographic Surgery (MMS)
Effective: 10/01/2018 | Posted: 10/01/2018

MA11.017d, Trigger Point Injections
Effective: 10/01/2018 | Posted: 10/01/2018

MA11.047c, Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and Canthoplasty/Canthopexy
Effective: 10/01/2018 | Posted: 10/01/2018

MA11.056e, Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery
Effective: 10/01/2018 | Posted: 10/01/2018

MA11.068b, Sentinel Lymph Node Biopsy
Effective: 10/01/2018 | Posted: 10/02/2018

MA08.031c, Cetuximab (Erbitux®)
Effective: 10/01/2018 | Posted: 10/02/2018

MA07.023d, Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
Effective: 10/01/2018 | Posted: 10/29/2018










Connect with Us        


© 2017 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.