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.
MA08.022i, Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®)
Notification: 02/13/2020 | Effective: 05/15/2020 | Posted: 02/13/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.018e, Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)
Notification: 02/13/2020 | Effective: 05/15/2020 | Posted: 02/13/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA08.072f, Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use
Notification: 02/13/2020 | Effective: 05/15/2020 | Posted: 02/13/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding

MA00.010y, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Notification: 02/14/2020 (Rivised 04/01/2020) | Effective: 05/18/2020 | Posted: 02/14/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding

MA09.002m, High-Technology Radiology Services
Notification: 02/17/2020 | Effective: 05/17/2020 | Posted: 02/17/2020
Type of policy change: Medical Necessity Criteria

MA10.004g, Chiropractic Services
Notification: 02/18/2020 | Effective: 05/18/2020 | Posted: 02/18/2020


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.
MA09.002l, High-Technology Radiology Services
Notification: 11/11/2019 | Effective: 02/09/2020 | Posted: 02/10/2020
Type of policy change: Medical Necessity Criteria

MA08.108b, Polatuzumab Vedotin-Piiq (Polivy™)
Effective: 02/10/2020 | Posted: 02/10/2020
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA07.058h, Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies
Notification: 11/27/2019 | Effective: 02/09/2020 | Posted: 02/10/2020
Type of policy change: Medical Necessity Criteria

MA08.006f, Siltuximab (Sylvant®)
Effective: 02/24/2020 | Posted: 02/24/2020
Type of policy change: 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.
MA06.004a, In Vivo Allergy Sensitivity Testing
Reissue Effective: 02/12/2020 | Reissue Posted: 02/13/2020

MA07.055c, Allergy Immunotherapy
Reissue Effective: 02/12/2020 | Reissue Posted: 02/13/2020

MA07.022b, Wireless Capsule Endoscopy
Reissue Effective: 02/12/2020 | Reissue Posted: 02/13/2020

MA06.002b, In Vitro Allergy Testing
Reissue Effective: 02/12/2020 | Reissue Posted: 02/13/2020

MA08.098a, Tildrakizumab-asmn (Ilumya™)
Reissue Effective: 02/12/2020 | Reissue Posted: 02/13/2020

MA01.004a, Continuous Local Delivery of Anesthesia to Operative Sites Using an Elastomeric Infusion Pump
Reissue Effective: 02/12/2020 | Reissue Posted: 02/13/2020

MA05.012a, Orthopedic Footwear
Reissue Effective: 02/14/2020 | Reissue Posted: 02/14/2020

MA05.035b, Cold Therapy Devices
Reissue Effective: 02/14/2020 | Reissue Posted: 02/14/2020

MA05.059, Electrical Continence Aid
Reissue Effective: 02/14/2020 | Reissue Posted: 02/14/2020

MA05.037, Walkers
Reissue Effective: 02/14/2020 | Reissue Posted: 02/14/2020

MA05.036b, Commode Chairs
Reissue Effective: 02/14/2020 | Reissue Posted: 02/14/2020

MA05.050a, Eye Prostheses and Scleral Cover Shell
Reissue Effective: 02/14/2020 | Reissue Posted: 02/14/2020

MA05.052b, Canes and Crutches
Reissue Effective: 02/14/2020 | Reissue Posted: 02/14/2020

MA05.029b, Heating Pads and Heat Lamps
Reissue Effective: 02/14/2020 | Reissue Posted: 02/14/2020

MA11.036c, Surgical Treatment of Nails
Reissue Effective: 02/14/2020 | Reissue Posted: 02/14/2020

MA09.013a, Screening for Vertebral Fracture with Dual-Energy X-ray Absorptiometry (DEXA/DXA)
Reissue Effective: 02/26/2020 | Reissue Posted: 02/27/2020

MA09.014a, Computer Aided Detection (CAD) System for Use with Chest Radiographs
Reissue Effective: 02/26/2020 | Reissue Posted: 02/27/2020

MA09.021c, Magnetic Resonance Imaging (MRI)--Guided Focused Ultrasound Ablation
Reissue Effective: 02/28/2020 | Reissue Posted: 02/28/2020

MA05.067b, Leadless Pacemakers
Reissue Effective: 02/28/2020 | Reissue Posted: 02/28/2020

MA05.054d, Urological Supplies
Reissue Effective: 02/28/2020 | Reissue Posted: 02/28/2020

MA07.053a, Nonemergent Inpatient Video Electroencephalogram (EEG) Monitoring and Ambulatory EEG Monitoring in the Home
Reissue Effective: 02/28/2020 | Reissue Posted: 02/28/2020

MA05.033b, External Breast Prosthesis
Reissue Effective: 02/28/2020 | Reissue Posted: 02/28/2020

MA05.034, Tracheostomy Care Supplies
Reissue Effective: 02/28/2020 | Reissue Posted: 02/28/2020

MA10.008d, Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)
Reissue Effective: 02/28/2020 | Reissue Posted: 02/28/2020










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