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.
MA08.056c, Eribulin Mesylate (Halaven®)
Notification: 12/26/2018 | Effective: 03/25/2019 | Posted: 12/26/2018
Type of policy change: Coverage and/or Reimbursement Position

MA08.011d, Erythropoiesis Stimulating Agents (ESAs)
Notification: 12/28/2018 | Effective: 01/28/2019 | Posted: 12/28/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA10.003e, Physical Medicine & Rehabilitation Services: Physical Therapy (PT) and Occupational Therapy (OT)
Notification: 12/28/2018 | Effective: 01/28/2019 | Posted: 12/28/2018
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update


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.
MA08.102, Mogamulizumab-kpkc (Poteligeo®)
Effective: 01/01/2019 | Posted: 12/31/2018
Type of policy change: This is a new policy.

MA08.103, Moxetumomab pasudotox-tdfk (Lumoxiti™)
Effective: 12/31/2018 | Posted: 12/31/2018
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.
MA08.078c, Sebelipase alfa (Kanuma®)
Notification: 09/04/2018 | Effective: 12/03/2018 | Posted: 12/03/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA08.086d, Nusinersen (Spinraza™)
Effective: 12/17/2018 | Posted: 12/17/2018
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA07.030b, Photodynamic Therapy (PDT) Using Porfimer Sodium (Photofrin®)
Effective: 12/17/2018 | Posted: 12/17/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding

MA08.048c, Ofatumumab (Arzerra™)
Effective: 12/17/2018 | Posted: 12/17/2018
Type of policy change: Medical Necessity Criteria

MA08.003d, Enteral Nutritional Therapy
Notification: 10/01/2018 | Effective: 01/01/2019 | Posted: 12/31/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA00.003j, Preventive Care Services
Notification: 11/30/2018 | Effective: 01/01/2019 | Posted: 12/31/2018
Type of policy change: Medical Necessity Criteria; Medical Coding

MA00.040a, Facility Reporting of Observation Services
Notification: 11/30/2018 | Effective: 01/01/2019 | Posted: 12/31/2018
Type of policy change: Coverage and/or Reimbursement Position

MA00.009f, Reporting and Documentation Requirements for Anesthesia Services
Notification: 10/01/2018 | Effective: 01/01/2019 | Posted: 12/31/2018

MA08.060c, Pegloticase (Krystexxa®)
Notification: 10/01/2018 | Effective: 01/01/2019 | Posted: 12/31/2018
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

MA08.049e, Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-bound)/(Abraxane® for Injectable Suspension)
Effective: 12/31/2018 | Posted: 12/31/2018
Type of policy change: Medical Necessity Criteria; Medical Coding

MA08.004m, Coagulation Factors
Effective: 01/01/2019 | Posted: 12/31/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.052d, Denosumab (Prolia®, Xgeva®)
Effective: 12/31/2018 | Posted: 12/31/2018
Type of policy change: Medical Necessity Criteria; Medical Coding

MA08.075c, Ramucirumab (Cyramza®)
Effective: 12/31/2018 | Posted: 12/31/2018
Type of policy change: 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.
MA11.047c, Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and Canthoplasty/Canthopexy
Reissue Effective: 12/05/2018 | Reissue Posted: 12/06/2018

MA11.033b, Solid Organ Transplantation and Procurement Cost of Organs and Tissues
Reissue Effective: 12/05/2018 | Reissue Posted: 12/06/2018

MA11.050, Treatment of Medical and Surgical Complications
Reissue Effective: 12/05/2018 | Reissue Posted: 12/06/2018

MA07.058f, Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies
Reissue Effective: 12/19/2018 | Reissue Posted: 12/19/2018

MA08.045d, Tocilizumab (Actemra®) for Intravenous Infusion
Reissue Effective: 12/19/2018 | Reissue Posted: 12/19/2018

MA08.054b, Cabazitaxel (Jevtana®)
Reissue Effective: 12/19/2018 | Reissue Posted: 12/19/2018

MA05.010d, Ankle-Foot/Knee-Ankle-Foot Orthoses
Reissue Effective: 12/19/2018 | Reissue Posted: 12/19/2018

MA06.007b, Loss-of-Heterozygosity-Based Topographic Genotyping with PathFinderTG®
Reissue Effective: 12/19/2018 | Reissue Posted: 12/19/2018

MA05.024b, Lower Limb Prostheses
Reissue Effective: 12/19/2018 | Reissue Posted: 12/20/2018

MA09.014a, Computer Aided Detection (CAD) System for Use with Chest Radiographs
Reissue Effective: 12/19/2018 | Reissue Posted: 12/20/2018

MA11.005b, Deep Brain Stimulation (DBS)
Reissue Effective: 12/20/2018 | Reissue Posted: 12/20/2018

MA11.051a, Treatment of Obesity and Bariatric Surgery for Treatment of Morbid Obesity
Reissue Effective: 12/20/2018 | Reissue Posted: 12/20/2018


Archived Policies
Independence Blue Cross has determined that it is no longer necessary for the following Medicare Advantage policy to remain active.
MA11.085a, Arthroscopic Electrothermal Joint Repair
Notification: 12/28/2018 | Archive Effective: 01/28/2019 | Posted: 12/28/2018










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