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.
MA00.005m, Experimental/Investigational Services
Notification: 01/02/2018 (Revised 03/29/2018) | Effective: 04/01/2018 | Posted: 01/02/2018
Type of policy change: Medical Coding

MA00.010s, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Notification: 01/03/2017 (Revised 01/11/2018, 02/23/2018) | Effective: 04/01/2018 | Posted: 01/03/2018

MA08.083a, Gonadotropin-Releasing Hormone Agonist (Eligard®, Lupron Depot®)
Notification: 01/19/2018 | Effective: 02/19/2018 | Posted: 01/19/2018
Type of policy change: Medical Necessity Criteria; 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.
MA00.047, Musculoskeletal Services
Notification: 10/03/2017 | Effective: 01/02/2018 | Posted: 01/02/2018
Type of policy change: This is a new policy.

MA11.113, Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound
Notification: 10/03/2017 | Effective: 01/02/2018 | Posted: 01/02/2018
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.
MA06.025e, Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
Notification: 10/13/2017 | Effective: 01/01/2018 | Posted: 01/02/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.024c, Percutaneous Vertebroplasty and Percutaneous Vertebral Augmentation
Effective: 01/02/2018 | Posted: 01/02/2018

MA11.041a, Spinal Laminectomy
Effective: 01/02/2018 | Posted: 01/02/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.084b, Osteochondral Autograft Transplantation Procedure
Effective: 01/02/2018 | Posted: 01/02/2018

MA11.082b, Autologous Chondrocyte Implantation (ACI)/Carticel® and Other Cell-based Treatments of Focal Articular Cartilage Lesions
Effective: 01/02/2018 | Posted: 01/02/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.108b, Spinal Fusion
Effective: 01/02/2018 | Posted: 01/02/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.086b, Osteochondral Allograft Transplantation
Effective: 01/02/2018 | Posted: 01/02/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria

MA00.036c, Remote Patient Management: Telemedicine Services
Effective: 01/01/2018 | Posted: 01/05/2018
Type of policy change: Medical Necessity Criteria

MA07.015a, Evaluation and Management (E&M) of Diabetic Peripheral Neuropathy with Loss of Protective Sensation (LOPS)
Effective: 06/28/2017 | Posted: 01/12/2018
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

MA08.036b, Alglucosidase alfa (e.g., Lumizyme®)
Notification: 12/22/2017 | Effective: 01/22/2018 | Posted: 01/22/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA05.044e, Durable Medical Equipment (DME)
Notification: 12/27/2017 | Effective: 01/26/2018 | Posted: 01/26/2018
Type of policy change: Medical Coding

MA05.007b, Nebulizers and Inhalation Solutions
Notification: 12/27/2017 | Effective: 01/26/2018 | Posted: 01/26/2018
Type of policy change: Medical Coding

MA05.010d, Ankle-Foot/Knee-Ankle-Foot Orthoses
Notification: 12/27/2017 | Effective: 01/26/2018 | Posted: 01/26/2018
Type of policy change: Medical Coding


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.
MA06.001e, Apheresis Therapy
Effective: 01/01/2018 | Posted: 01/02/2018

MA11.002e, Hematopoietic Stem Cell Transplantation
Effective: 01/01/2018 | Posted: 01/02/2018

MA00.028b, Outpatient Short-Term Rehabilitation Services Included in Capitation
Effective: 01/01/2018 | Posted: 01/05/2018

MA00.014c, Modifier 66: Surgical Team
Effective: 01/01/2018 | Posted: 01/05/2018

MA00.015c, Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS
Effective: 01/01/2018 | Posted: 01/05/2018

MA00.027f, Diagnostic Radiology Services Included in Capitation
Effective: 01/01/2018 | Posted: 01/05/2018

MA00.011d, Modifier 62: Two Surgeons
Effective: 01/01/2018 | Posted: 01/05/2018

MA03.003d, 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
Effective: 01/01/2018 | Posted: 01/05/2018

MA00.029e, 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: 01/01/2018 | Posted: 01/05/2018

MA03.002b, Modifier 50: Bilateral Procedure
Effective: 01/01/2018 | Posted: 01/05/2018

MA00.037e, Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
Effective: 01/01/2018 | Posted: 01/05/2018

MA00.019d, Radiologic Guidance of a Procedure
Effective: 01/01/2018 | Posted: 01/08/2018

MA00.018b, Prolonged Face-to-Face Physician Services
Effective: 01/01/2018 | Posted: 01/08/2018

MA09.009h, Diagnostic and Therapeutic Radiopharmaceutical Agents
Effective: 01/01/2018 | Posted: 01/08/2018

MA00.009e, Reporting and Documentation Requirements for Anesthesia Services
Effective: 01/01/2018 | Posted: 01/09/2018

MA01.005a, Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services
Effective: 01/01/2018 | Posted: 01/09/2018

MA00.030l, Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
Effective: 01/01/2018 | Posted: 01/09/2018

MA03.012b, Modifier 79: Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Effective: 01/01/2018 | Posted: 01/10/2018

MA03.010c, Modifier 57: Decision for Surgery
Effective: 01/01/2018 | Posted: 01/10/2018

MA03.009c, Modifier 24: Unrelated Evaluation and Management Service by the Same Physician during a Postoperative Period
Effective: 01/01/2018 | Posted: 01/10/2018

MA11.037c, Use of an Operating Microscope During a Surgical Procedure
Effective: 01/01/2018 | Posted: 01/10/2018

MA00.010r, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Effective: 01/01/2018 | Posted: 01/10/2018

MA03.011c, Modifiers 26 (Professional Component) and TC (Technical Component)
Effective: 01/01/2018 | Posted: 01/12/2018

(Not Categorized)
MA11.105d, Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma
Notification: 11/01/2017 | Effective: 01/30/2018 | Posted: 01/30/2018










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