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
 
                                                                                                        

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.
MA11.065c, Endometrial Ablation
Effective: 01/06/2017 | Posted: 01/06/2017
Type of policy change: Medical Necessity Criteria; Medical Coding

MA11.028c, Sacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for the Control of Incontinence
Notification: 11/30/2016 | Effective: 01/06/2017 | Posted: 01/06/2017

MA11.102d, Denervation of the Spinal Nerves for Chronic Pain
Effective: 01/06/2017 | Posted: 01/06/2017
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA09.009g, Diagnostic and Therapeutic Radiopharmaceutical Agents
Effective: 01/01/2017 | Posted: 01/06/2017
Type of policy change: Coverage and/or Reimbursement Position

MA12.001b, Complementary and Integrative Health Services
Effective: 01/11/2017 | Posted: 01/11/2017
Type of policy change: General Description, Guidelines, or Informational Update

MA06.006b, Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Treatment
Effective: 01/11/2017 | Posted: 01/11/2017
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.044c, Artificial Intervertebral Disc Insertion
Effective: 01/13/2017 | Posted: 01/13/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA00.023a, Inpatient Hospital Readmission
Notification: 12/15/2016 | Effective: 01/15/2017 | Posted: 01/13/2017
Type of policy change: General Description, Guidelines, or Informational Update

MA11.017c, Trigger Point Injections
Effective: 01/13/2017 | Posted: 01/13/2017
Type of policy change: Medical Coding

MA07.056a, Photodynamic Therapy (PDT) Using Levulan® Kerastick® (Aminolevulinic Acid HCl [ALA]) or Metvixia® (Methyl Aminolevulinate [MAL])
Effective: 01/18/2017 | Posted: 01/18/2017
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.010e, Programmed Death Receptor-1 (PD-1) Antagonists (e.g., Keytruda®, Opdivo®) and Programmed Death-Ligand 1 (PD-L1) Antagonist (e.g., Tecentriq®)
Effective: 01/25/2017 | Posted: 01/25/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA02.002, Private Duty Nursing
Reissue Effective: 01/04/2017 | Reissue Posted: 01/04/2017

MA01.004a, Continuous Local Delivery of Anesthesia to Operative Sites Using an Elastomeric Infusion Pump
Reissue Effective: 01/18/2017 | Reissue Posted: 01/18/2017

MA11.100b, Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis
Reissue Effective: 01/18/2017 | Reissue Posted: 01/18/2017


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.
MA11.026b, Epidural, Paravertebral Facet, and Sacroiliac Joint Injections for Spinal Pain Management
Effective: 01/01/2017 | Posted: 01/03/2017

MA11.001c, Treatment of Varicose Veins of the Lower Extremities and Perforator Vein Incompetence
Effective: 01/01/2017 | Posted: 01/03/2017

MA11.013a, Percutaneous Left Atrial Appendage (LAA) Closure for Non-Valvular Atrial Fibrillation (NVAF)
Effective: 01/01/2017 | Posted: 01/03/2017

MA10.003b, Physical Medicine & Rehabilitation Services: Physical Therapy (PT) and Occupational Therapy (OT)
Effective: 01/01/2017 | Posted: 01/03/2017

MA11.096a, Percutaneous Discectomy
Effective: 01/01/2017 | Posted: 01/03/2017

MA11.087b, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
Effective: 01/01/2017 | Posted: 01/03/2017

MA11.097b, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis
Effective: 01/01/2017 | Posted: 01/03/2017

MA11.108a, Spinal Fusion
Effective: 01/01/2017 | Posted: 01/03/2017

MA11.105c, Aqueous Shunts, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma
Effective: 01/01/2017 | Posted: 01/03/2017

MA05.021a, Injectable Dermal Fillers
Effective: 01/01/2017 | Posted: 01/03/2017

MA00.024b, Reporting Requirements for Drugs and Biologics
Effective: 01/01/2017 | Posted: 01/06/2017

MA00.028a, Outpatient Short-Term Rehabilitation Services Included in Capitation
Effective: 01/01/2017 | Posted: 01/06/2017

MA03.010b, Modifier 57: Decision for Surgery
Effective: 01/01/2017 | Posted: 01/06/2017

MA03.009b, Modifier 24: Unrelated Evaluation and Management Service by the Same Physician during a Postoperative Period
Effective: 01/01/2017 | Posted: 01/06/2017

MA03.012a, Modifier 79: Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Effective: 01/01/2017 | Posted: 01/06/2017

MA03.003b, Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Day of a Procedure or Other Service
Effective: 01/01/2017 | Posted: 01/06/2017

MA00.027e, Diagnostic Radiology Services Included in Capitation
Effective: 01/01/2017 | Posted: 01/06/2017

MA00.026c, Always Bundled Procedure Codes
Effective: 01/01/2017 | Posted: 01/06/2017

MA11.032d, Multiple Surgical Reduction Guidelines
Effective: 01/01/2017 | Posted: 01/06/2017

MA00.030f, Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
Effective: 01/01/2017 | Posted: 01/06/2017

MA00.037c, Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
Effective: 01/01/2017 | Posted: 01/06/2017










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