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
 
                                                                                                        

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.
MA11.013, Percutaneous Left Atrial Appendage (LAA) Closure for Non-Valvular Atrial Fibrillation (NVAF)
Effective: 01/01/2016 | Posted: 03/04/2016
Type of policy change: This is a new policy.

MA08.044b, Eculizumab (Soliris®)
Effective: 03/23/2016 | Posted: 03/23/2016
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.
MA00.024a, Reporting Requirements for Drugs and Biologics
Notification: 01/01/2016 | Effective: 03/01/2016 | Posted: 03/01/2016
Type of policy change: This is a new policy.

MA08.009b, Immune Globulin: Intravenous (IVIG), Subcutaneous (SCIG)
Notification: 12/02/2015 | Effective: 03/01/2016 | Posted: 03/01/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA05.003b, Speech and Non-Speech Generating Devices
Effective: 03/09/2016 | Posted: 03/09/2016

MA00.033b, Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers
Effective: 03/18/2016 | Posted: 03/18/2016

MA08.062b, Carfilzomib (Kyprolis™)
Effective: 03/23/2016 | Posted: 03/23/2016
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA00.038a, Marijuana for Medical Use
Effective: 03/23/2016 | Posted: 03/23/2016
Type of policy change: Medical Necessity Criteria

MA08.068a, Brentuximab Vedotin (Adcetris®)
Effective: 03/23/2016 | Posted: 03/23/2016
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.021a, Non-Surgical Spinal Decompression Therapy
Effective: 03/28/2016 | Posted: 03/28/2016
Type of policy change: Medical Coding

MA08.026a, Complex Regional Pain Syndrome (CRPS) Parenteral Treatments
Notification: 12/30/2015 | Effective: 03/29/2016 | Posted: 03/29/2016
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.
MA05.030a, Spinal Orthoses
Reissue Effective: 02/03/2016 | Reissue Posted: 03/01/2016

MA07.006, Fecal Microbiota Transplantation (FMT)
Reissue Effective: 03/02/2016 | Reissue Posted: 03/03/2016

MA07.030a, Photodynamic Therapy (PDT) using Porfimer Sodium (Photofrin®)
Reissue Effective: 03/02/2016 | Reissue Posted: 03/03/2016

MA07.016a, Intravenous Chelation Therapy
Reissue Effective: 03/02/2016 | Reissue Posted: 03/03/2016

MA11.007, Islet Cell Transplantation
Reissue Effective: 03/02/2016 | Reissue Posted: 03/03/2016

MA11.008, Refractive Keratoplasty
Reissue Effective: 03/02/2016 | Reissue Posted: 03/03/2016

MA11.068a, Sentinel Lymph Node Biopsy
Reissue Effective: 03/02/2016 | Reissue Posted: 03/03/2016

MA07.039a, Magnetoencephalography (MEG) with Magnetic Source Imaging (MSI)
Reissue Effective: 03/02/2016 | Reissue Posted: 03/03/2016

MA05.005, Automatic External and Wearable Cardioverter Defibrillators
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA08.036a, Alglucosidase alfa (e.g., Myozyme®, Lumizyme®)
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA05.009, Cervical Traction Devices for In-home Use
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA05.025, Pressure-Reducing Support Surfaces
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA05.055, Standing Frames
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA04.001, Dental Extractions Prior to Cardiac Surgery, Radiation Therapy, or Transplant Surgery
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA07.011a, Topical Oxygenation
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA08.023a, Enzyme Replacement for the Treatment of Gaucher's Disease
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA11.087a, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA09.011a, Electron Beam Computed Tomography (EBCT) for Screening Evaluations
Reissue Effective: 03/30/2016 | Reissue Posted: 03/16/2016

MA09.015, Positron Emission Mammography (PEM)
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA11.046, Hair Transplants and Cranial Prostheses (Wigs)
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA11.059, Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee
Reissue Effective: 03/16/2016 | Reissue Posted: 03/16/2016

MA06.014b, Pharmacogenetics and Metabolite Monitoring for Using Azathioprine (AZA)/6-Mercaptopurine (6-MP) Therapy
Reissue Effective: 03/16/2016 | Reissue Posted: 03/22/2016

MA06.018a, Immune Cell Function Assay
Reissue Effective: 03/16/2016 | Reissue Posted: 03/22/2016

MA06.011a, Human Immunodeficiency Virus (HIV) Genotyping and Phenotyping
Reissue Effective: 03/16/2016 | Reissue Posted: 03/22/2016

MA06.013b, Serodiagnosis of Inflammatory Bowel Disease (IBD) and the Prometheus® IBD sgi Diagnostic™ Test
Reissue Effective: 03/16/2016 | Reissue Posted: 03/22/2016

MA06.015b, AlloMap™ Molecular Expression Testing for Heart Transplant Rejection
Reissue Effective: 03/16/2016 | Reissue Posted: 03/22/2016

MA07.003a, Photodynamic Therapy Using Verteporfin (Visudyne®)
Reissue Effective: 03/30/2016 | Reissue Posted: 03/30/2016

MA08.033a, Agalsidase beta (Fabrazyme®)
Reissue Effective: 03/30/2016 | Reissue Posted: 03/30/2016

MA10.005a, Day Rehabilitation
Reissue Effective: 03/30/2016 | Reissue Posted: 03/30/2016

MA11.010, Abortion
Reissue Effective: 03/30/2016 | Reissue Posted: 03/30/2016

MA05.007a, Nebulizers
Reissue Effective: 03/30/2016 | Reissue Posted: 03/30/2016

MA05.015, Home Blood Glucose Monitors and Supplies
Reissue Effective: 03/30/2016 | Reissue Posted: 03/31/2016

MA05.064, Percutaneous Electrical Nerve Stimulation (PENS) and Percutaneous Neuromodulation Therapy (PNT)
Reissue Effective: 03/30/2016 | Reissue Posted: 03/31/2016

MA05.016, Home Prothrombin Time Monitoring
Reissue Effective: 03/30/2016 | Reissue Posted: 03/31/2016


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.
MA00.027c, Diagnostic Radiology Services Included in Capitation
Notification: 12/01/2015 | Effective: 03/01/2016 | Posted: 03/01/2016


Archived Policies
Independence Blue Cross has determined that it is no longer necessary for the following Medicare Advantage policy to remain active.
MA00.008, Infusion Therapy Services as Performed by Home Infusion Providers
Effective: 01/01/2015 | Posted: 03/01/2016

MA11.053, Sterilization
Notification: 03/30/2016 | Archive Effective: 04/29/2016 | Posted: 03/30/2016










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