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.
MA07.053, Nonemergent Inpatient Video Electroencephalogram (EEG) Monitoring and Ambulatory EEG Monitoring in the Home
Notification: 03/30/2018 | Effective: 04/30/2018 | Posted: 03/30/2018
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.
MA11.102e, Denervation of the Spinal Nerves for Chronic Pain
Notification: 12/01/2017 | Effective: 03/01/2018 | Posted: 03/01/2018
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.026c, Epidural, Paravertebral Facet, and Sacroiliac Joint Injections for Spinal Pain Management
Notification: 12/01/2017 | Effective: 03/01/2018 | Posted: 03/01/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.031f, Spinal Cord and Dorsal Root Ganglion Stimulation
Effective: 03/01/2018 | Posted: 03/01/2018

MA07.058f, Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies
Notification: 12/01/2017 | Effective: 03/01/2018 | Posted: 03/01/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.026e, Treatments for Complex Regional Pain Syndrome (CRPS)
Notification: 12/01/2017 | Effective: 03/01/2018 | Posted: 03/01/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA00.047a, Musculoskeletal Services
Notification: 12/01/2017 | Effective: 03/01/2018 | Posted: 03/01/2018
Type of policy change: This is a new policy.

MA08.070c, Golimumab (Simponi® Aria™) Intravenous (IV) Injection
Effective: 03/07/2018 | Posted: 03/07/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA05.019a, Continuous Passive Motion (CPM) Devices in the Home Setting
Effective: 03/07/2018 | Posted: 03/07/2018
Type of policy change: General Description, Guidelines, or Informational Update

MA08.018b, Trastuzumab (Herceptin®) and Related Biosimilars
Effective: 03/09/2018 | Posted: 03/09/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.034b, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase™, Vimizim™, Naglazyme®, Mepsevii™, etc.)
Effective: 03/16/2018 | Posted: 03/16/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA07.007d, Pulmonary Function Tests
Notification: 02/21/2018 | Effective: 03/23/2018 | Posted: 03/23/2018
Type of policy change: Medical Coding

MA07.044b, Measurement of Exhaled Nitric Oxide and Breath Condensate in the Diagnosis and Management of Asthma and Other Respiratory Disorders
Effective: 03/26/2018 | Posted: 03/26/2018
Type of policy change: Coverage and/or Reimbursement Position; General Description, Guidelines, or Informational Update

MA11.062a, Endovascular Stent-Graft Repair of Thoracic Aortic Aneurysms and Nonaneurysmal Lesions
Effective: 03/26/2018 | Posted: 03/26/2018
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

MA11.012c, Endovascular Grafts for Abdominal Aortic Aneurysms, Aortic-Iliac Aneurysms, and Infrarenal Aortic Aneurysms
Effective: 03/26/2018 | Posted: 03/26/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.001f, Treatment of Varicose Veins of the Lower Extremities and Perforator Vein Incompetence
Notification: 12/27/2017 | Effective: 03/27/2018 | Posted: 03/27/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.018b, Mohs' Micrographic Surgery (MMS)
Notification: 12/27/2017 | Effective: 03/27/2018 | Posted: 03/27/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA07.038c, Neuropsychological Testing for Neurologically Based Conditions
Notification: 12/27/2017 | Effective: 03/27/2018 | Posted: 03/27/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA00.003i, Preventive Care Services
Effective: 04/01/2018 | Posted: 03/30/2018
Type of policy change: Medical Necessity Criteria; Medical Coding


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA05.064, Percutaneous Electrical Nerve Stimulation (PENS) and Percutaneous Neuromodulation Therapy (PNT)
Reissue Effective: 03/14/2018 | Reissue Posted: 03/14/2018

MA07.036b, Low-Level Laser Therapy
Reissue Effective: 03/14/2018 | Reissue Posted: 03/14/2018

MA05.009, Cervical Traction Devices for In-home Use
Reissue Effective: 03/14/2018 | Reissue Posted: 03/14/2018

MA05.030c, Spinal Orthoses
Reissue Effective: 03/14/2018 | Reissue Posted: 03/14/2018

MA11.010a, Abortion
Reissue Effective: 03/14/2018 | Reissue Posted: 03/14/2018

MA05.003c, Speech and Non-Speech Generating Devices
Reissue Effective: 03/28/2018 | Reissue Posted: 03/28/2018

MA05.052b, Canes and Crutches
Reissue Effective: 03/28/2018 | Reissue Posted: 03/29/2018

MA11.046a, Hair Transplants and Cranial Prostheses (Wigs)
Reissue Effective: 03/28/2018 | Reissue Posted: 03/29/2018

MA08.057a, Belimumab (Benlysta®)
Reissue Effective: 03/28/2018 | Reissue Posted: 03/29/2018

MA11.008b, Refractive Keratoplasty
Reissue Effective: 03/28/2018 | Reissue Posted: 03/29/2018

MA11.054b, Cataract Surgery
Reissue Effective: 03/28/2018 | Reissue Posted: 03/29/2018

MA11.063a, Photocoagulation of Macular Drusen
Reissue Effective: 03/28/2018 | Reissue Posted: 03/29/2018

MA07.001a, Hyperbaric Oxygen Therapy
Reissue Effective: 03/28/2018 | Reissue Posted: 03/29/2018


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.
MA08.019d, Infliximab and Related Biosimilars
Effective: 04/01/2018 | Posted: 03/30/2018

MA08.004j, Coagulation Factors
Effective: 04/01/2018 | Posted: 03/30/2018

MA05.020d, Therapeutic Shoes
Effective: 04/01/2018 | Posted: 03/30/2018

MA11.002f, Hematopoietic Stem Cell Transplantation
Effective: 04/01/2018 | Posted: 03/30/2018

MA08.022e, Rituximab (Rituxan®) infusion, and rituximab and hyaluronidase human (Rituxan Hycela™) for subcutaneous injection
Effective: 04/01/2018 | Posted: 03/30/2018

MA08.091a, Aprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®)
Effective: 04/01/2018 | Posted: 03/30/2018

MA08.093b, Chimeric Antigen Receptor (CAR) Therapy
Effective: 04/01/2018 | Posted: 03/30/2018


Archived Policies
Independence Blue Cross has determined that it is no longer necessary for the following Medicare Advantage policy to remain active.
MA08.081, Fulvestrant (Faslodex®)
Notification: 03/14/2018 | Archive Effective: 04/16/2018 | Posted: 03/14/2018

MA08.080, Daptomycin (Cubicin®)
Notification: 03/14/2018 | Archive Effective: 04/16/2018 | Posted: 03/14/2018

MA08.064a, Omacetaxine Mepesuccinate (Synribo®)
Notification: 03/14/2018 | Archive Effective: 04/16/2018 | Posted: 03/14/2018

MA11.061a, Transcoronary Ablation of Septal Hypertrophy (TASH)
Notification: 03/14/2018 | Archive Effective: 04/16/2018 | Posted: 03/14/2018

MA11.059, Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee
Notification: 03/15/2018 | Archive Effective: 04/13/2018 | Posted: 03/15/2018

MA11.003, Lung Volume Reduction Surgery (LVRS)
Notification: 03/16/2018 | Archive Effective: 04/16/2018 | Posted: 03/16/2018

MA11.104a, Lacrimal Punctum Plugs
Notification: 03/21/2018 | Archive Effective: 04/23/2018 | Posted: 03/21/2018










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