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.
MA00.009g, Reporting and Documentation Requirements for Anesthesia Services
Notification: 01/22/2020 | Effective: 04/21/2020 | Posted: 01/22/2020
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.
MA08.073f, Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists and Related Biosimilars
Notification: 10/03/2019 | Effective: 01/01/2020 | Posted: 01/02/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.042h, Ustekinumab (Stelara®)
Effective: 01/06/2020 | Posted: 01/06/2020
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA10.005b, Day Rehabilitation
Notification: 12/13/2019 | Effective: 01/13/2020 | Posted: 01/13/2020

MA08.060d, Pegloticase (Krystexxa®)
Notification: 10/15/2019 | Effective: 01/13/2020 | Posted: 01/13/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA00.037h, Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
Effective: 01/13/2020 | Posted: 01/13/2020
Type of policy change: Medical Coding

MA03.018a, Modifier 53 Discontinued Procedure
Effective: 01/13/2020 | Posted: 01/13/2020
Type of policy change: General Description, Guidelines, or Informational Update

MA03.014a, Modifier 52 Reduced Services
Effective: 01/13/2020 | Posted: 01/13/2020
Type of policy change: General Description, Guidelines, or Informational Update

MA09.020j, Radiation Therapy Services
Notification: 10/21/2019 | Effective: 01/21/2020 | Posted: 01/21/2020
Type of policy change: General Description, Guidelines, or Informational Update

MA00.005t, Experimental/Investigational Services
Notification: 10/29/2019 | Effective: 01/27/2020 | Posted: 01/27/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA07.023e, Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
Reissue Effective: 01/09/2020 | Reissue Posted: 01/09/2020

MA04.002, Extraction of Bony Impacted Teeth and Exposure of Impacted Teeth
Reissue Effective: 01/09/2020 | Reissue Posted: 01/09/2020

MA11.051a, Treatment of Obesity and Bariatric Surgery for Treatment of Morbid Obesity
Reissue Effective: 01/09/2020 | Reissue Posted: 01/09/2020

MA05.058a, Neuromuscular Electrical Stimulators (NMES) and Functional Electrical Stimulators (FES)
Reissue Effective: 01/29/2020 | Reissue Posted: 01/31/2020

MA05.006d, Transcutaneous Electrical Nerve Stimulators (TENS) and Associated Supplies
Reissue Effective: 01/29/2020 | Reissue Posted: 01/31/2020


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.
MA00.036f, Telehealth Services
Effective: 01/01/2020 | Posted: 01/01/2020

MA06.019c, Measurement of Serum Antibodies to and Measurement of Serum Levels of Biologics
Effective: 01/01/2020 | Posted: 01/01/2020

MA11.106e, Treatment of Gender Dysphoria
Effective: 01/01/2020 | Posted: 01/01/2020

MA06.013d, Serodiagnosis of Inflammatory Bowel Disease (IBD) and the Prometheus® IBD sgi Diagnostic™ Test
Effective: 01/01/2020 | Posted: 01/01/2020

MA06.021d, In Vitro Chemosensitivity and Chemoresistance Assays
Effective: 01/01/2020 | Posted: 01/01/2020

MA08.026f, Treatments for Complex Regional Pain Syndrome (CRPS)
Effective: 01/01/2020 | Posted: 01/02/2020

MA11.044f, Artificial Intervertebral Disc Insertion
Effective: 01/01/2020 | Posted: 01/02/2020

MA11.039d, Cochlear Implantation
Effective: 01/01/2020 | Posted: 01/02/2020

MA11.030e, Reconstructive Breast Surgery
Effective: 01/01/2020 | Posted: 01/02/2020

MA11.007a, Islet Cell Transplantation
Effective: 01/01/2020 | Posted: 01/02/2020

MA09.002k, High-Technology Radiology Services
Effective: 01/01/2020 | Posted: 01/02/2020

MA11.029f, Spinal Discectomy
Effective: 01/01/2020 | Posted: 01/02/2020

MA06.022f, Biomarkers for Oncology
Effective: 01/01/2020 | Posted: 01/03/2020

MA06.017r, Molecular Diagnostics
Effective: 01/01/2020 | Posted: 01/03/2020

MA06.025l, Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
Effective: 01/01/2020 | Posted: 01/03/2020

MA07.053a, Nonemergent Inpatient Video Electroencephalogram (EEG) Monitoring and Ambulatory EEG Monitoring in the Home
Effective: 01/01/2020 | Posted: 01/03/2020

MA07.005c, Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices
Effective: 01/01/2020 | Posted: 01/03/2020

MA07.008b, Platelet-Rich Plasma (PRPs) for Chronic Non-Healing Wounds and Stem-Cell Therapy for Orthopedic Applications
Effective: 01/01/2020 | Posted: 01/03/2020

MA11.054c, Cataract Surgery
Effective: 01/01/2020 | Posted: 01/03/2020

MA00.006f, Care Management and Care Planning Services
Effective: 01/01/2020 | Posted: 01/06/2020

MA00.037g, Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
Effective: 01/01/2020 | Posted: 01/06/2020

MA00.019f, Radiologic Guidance of a Procedure
Effective: 01/01/2020 | Posted: 01/06/2020

MA05.044g, Durable Medical Equipment (DME)
Effective: 01/01/2020 | Posted: 01/06/2020

MA00.011e, Modifier 62: Two Surgeons
Effective: 01/01/2020 | Posted: 01/06/2020

MA00.015d, Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS
Effective: 01/01/2020 | Posted: 01/06/2020

MA03.003g, 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: 01/01/2020 | Posted: 01/06/2020

MA03.002c, Modifier 50: Bilateral Procedure
Effective: 01/01/2020 | Posted: 01/13/2020

MA08.048d, Ofatumumab (Arzerra™)
Effective: 01/20/2020 | Posted: 01/21/2020

MA11.032e, Multiple Surgical Reduction Guidelines
Effective: 01/01/2020 | Posted: 01/22/2020

MA00.010x, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Effective: 01/01/2020 | Posted: 01/27/2020


Archived Policies
Independence Blue Cross has determined that it is no longer necessary for the following Medicare Advantage policy to remain active.
MA01.001, Anesthesia Services for a Cancelled or Discontinued Procedure
Notification: 01/22/2020 | Archive Effective: 04/21/2020 | Posted: 01/22/2020










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