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.
MA11.041c, Spinal Laminectomy
Notification: 03/11/2020 | Effective: 06/15/2020 | Posted: 03/11/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.102h, Denervation of the Spinal Nerves for Chronic Pain
Notification: 03/11/2020 | Effective: 06/15/2020 | Posted: 03/11/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.029g, Spinal Discectomy
Notification: 03/11/2020 | Effective: 06/15/2020 | Posted: 03/11/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.031h, Spinal Cord and Dorsal Root Ganglion Stimulation
Notification: 03/11/2020 | Effective: 06/15/2020 | Posted: 03/11/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.026f, Epidural, Paravertebral Facet, and Sacroiliac Joint Injections for Spinal Pain Management
Notification: 03/11/2020 | Effective: 06/15/2020 | Posted: 03/11/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.108d, Spinal Fusion
Notification: 03/11/2020 | Effective: 06/15/2020 | Posted: 03/11/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.044g, Artificial Intervertebral Disc Insertion
Notification: 03/11/2020 | Effective: 06/15/2020 | Posted: 03/11/2020
Type of policy change: General Description, Guidelines, or Informational Update

MA11.081b, Meniscal Allograft Transplantation and Meniscal Implants
Notification: 03/11/2020 | Effective: 06/15/2020 | Posted: 03/11/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA00.047c, Musculoskeletal Services
Notification: 03/11/2020 | Effective: 06/15/2020 | Posted: 03/11/2020
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; 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.
MA08.110, Luspatercept–aamt (Reblozyl®)
Effective: 03/09/2020 | Posted: 03/09/2020
Type of policy change: This is a new policy.

MA08.114, Fam-trastuzumab deruxtecan-nxki (Enhertu®)
Effective: 03/09/2020 | Posted: 03/09/2020
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.
MA08.050a, Alpha 1-Antitrypsin Therapy (e.g., Prolastin-C®, Aralast NP™, Glassia™, Zemaira™)
Notification: 12/03/2019 | Effective: 03/02/2020 | Posted: 03/02/2020
Type of policy change: Medical Necessity Criteria; Medical Coding

MA00.044b, Criteria for Reimbursement of Emergency Room Services
Effective: 03/23/2020 | Posted: 03/23/2020
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

MA11.032f, Multiple Surgery Payment Reduction
Notification: 12/30/2019 | Effective: 03/30/2020 | Posted: 03/30/2020
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA11.050, Treatment of Medical and Surgical Complications
Reissue Effective: 03/12/2020 | Reissue Posted: 03/12/2020

MA11.091b, Manipulation Under Anesthesia
Reissue Effective: 03/11/2020 | Reissue Posted: 03/12/2020

MA10.003f, Physical Medicine & Rehabilitation Services: Physical Therapy (PT) and Occupational Therapy (OT)
Reissue Effective: 03/11/2020 | Reissue Posted: 03/12/2020

MA07.007g, Pulmonary Function Tests
Reissue Effective: 03/11/2020 | Reissue Posted: 03/12/2020

MA11.097d, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis
Reissue Effective: 03/11/2020 | Reissue Posted: 03/12/2020

MA11.025, Percutaneous Intradiscal Annuloplasty (IDET/PIRFT)
Reissue Effective: 03/11/2020 | Reissue Posted: 03/12/2020

MA11.071a, Selective Photothermolysis Using Pulsed-Dye Lasers (PDL)
Reissue Effective: 03/11/2020 | Reissue Posted: 03/12/2020

MA06.015c, AlloMap™ Molecular Expression Testing for Heart Transplant Rejection
Reissue Effective: 03/25/2020 | Reissue Posted: 03/25/2020

MA06.011a, Human Immunodeficiency Virus (HIV) Genotyping and Phenotyping
Reissue Effective: 03/25/2020 | Reissue Posted: 03/25/2020

MA07.048a, Instrument-Based Vision Screening
Reissue Effective: 03/25/2020 | Reissue Posted: 03/25/2020

MA09.015, Positron Emission Mammography (PEM)
Reissue Effective: 03/25/2020 | Reissue Posted: 03/25/2020

MA06.013d, Serodiagnosis of Inflammatory Bowel Disease (IBD) and the Prometheus® IBD sgi Diagnostic™ Test
Reissue Effective: 03/25/2020 | Reissue Posted: 03/25/2020

MA06.025l, Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
Reissue Effective: 03/25/2020 | Reissue Posted: 03/25/2020

MA06.023c, Nerve Fiber Density Testing
Reissue Effective: 03/25/2020 | Reissue Posted: 03/25/2020

MA06.029, Therapeutic Drug Monitoring for Antidepressants, Antipsychotics, and Antiepileptics
Reissue Effective: 03/25/2020 | Reissue Posted: 03/25/2020

MA06.022f, Biomarkers for Oncology
Reissue Effective: 03/25/2020 | Reissue Posted: 03/25/2020

MA06.017r, Molecular Diagnostics
Reissue Effective: 03/25/2020 | Reissue Posted: 03/25/2020

MA07.052, Bioimpedance for the Detection of Lymphedema
Reissue Effective: 03/26/2020 | Reissue Posted: 03/26/2020

MA08.023b, Enzyme Replacement for the Treatment of Gaucher's Disease
Reissue Effective: 03/26/2020 | Reissue Posted: 03/26/2020

MA08.089c, Cerliponase alfa (Brineura®)
Reissue Effective: 03/26/2020 | Reissue Posted: 03/26/2020

MA07.017c, Hyperthermic Intraperitoneal Chemotherapy for Select IntraAbdominal and Pelvic Malignancies
Reissue Effective: 03/26/2020 | Reissue Posted: 03/26/2020

MA08.034d, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase®, Vimizim®, Naglazyme®, Mepsevii™, etc.)
Reissue Effective: 03/26/2020 | Reissue Posted: 03/26/2020

MA11.079c, Evaluation and Treatment of Erectile Dysfunction (ED)
Reissue Effective: 03/26/2020 | Reissue Posted: 03/26/2020

MA11.022a, Cryosurgical Ablation of the Prostate Gland
Reissue Effective: 03/26/2020 | Reissue Posted: 03/26/2020


Archived Policies
Independence Blue Cross has determined that it is no longer necessary for the following Medicare Advantage policy to remain active.
MA06.020a, Autologous Blood Services (Collection, Storage, Transfusion, and Perioperative Salvage)
Notification: 03/20/2020 | Archive Effective: 04/20/2020 | Posted: 03/20/2020










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