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.
MA05.004a, Pneumatic Compression Therapy Devices
Notification: 04/06/2016 | Effective: 05/06/2016 | Posted: 04/06/2016
Type of policy change: This is a new policy.

MA05.045a, Compression Garments
Notification: 04/06/2016 | Effective: 05/06/2016 | Posted: 04/06/2016

MA07.023, Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
Notification: 04/06/2016 | Effective: 07/05/2016 | Posted: 04/06/2016
Type of policy change: This is a new policy.

MA08.079, daratumumab (Darzalex)
Notification: 04/06/2016 | Effective: 05/06/2016 | Posted: 04/06/2016
Type of policy change: This is a new policy.

MA11.110, Surgery for Gynecomastia
Notification: 04/18/2016 | Effective: 05/18/2016 | Posted: 04/19/2016
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.
MA00.015a, Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS
Effective: 04/01/2016 | Posted: 04/01/2016
Type of policy change: Coverage and/or Reimbursement Position

MA11.065b, Endometrial Ablation
Effective: 04/01/2016 | Posted: 04/01/2016
Type of policy change: Medical Necessity Criteria; Medical Coding

MA05.028b, Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum
Notification: 12/31/2015 | Effective: 04/01/2016 | Posted: 04/01/2016

MA08.010d, Programmed Cell Death Receptor-1 (PD-1) antagonists (e.g., Keytruda®, Opdivo®)
Effective: 04/06/2016 | Posted: 04/06/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.076b, Removal of Breast Implants
Effective: 04/06/2016 | Posted: 04/06/2016
Type of policy change: General Description, Guidelines, or Informational Update

MA11.004c, Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)
Effective: 04/13/2016 | Posted: 04/13/2016
Type of policy change: Coverage and/or Reimbursement Position

MA08.060b, Pegloticase (Krystexxa®)
Effective: 04/20/2016 | Posted: 04/20/2016
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

MA00.003d, Preventive Care Services
Effective: 04/20/2016 | Posted: 04/20/2016


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA05.011, Seat Lift Mechanisms
Reissue Effective: 04/13/2016 | Reissue Posted: 04/13/2016

MA05.059, Electrical Continence Aid
Reissue Effective: 04/13/2016 | Reissue Posted: 04/13/2016

MA10.007, Speech Therapy
Reissue Effective: 04/13/2016 | Reissue Posted: 04/13/2016

MA11.097a, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis
Reissue Effective: 04/13/2016 | Reissue Posted: 04/13/2016

MA07.014, Magnetic Pelvic Floor Stimulation (MPFS)
Reissue Effective: 04/27/2016 | Reissue Posted: 04/27/2016

MA05.013a, Knee Braces
Reissue Effective: 04/13/2016 | Reissue Posted: 04/27/2016

MA11.079b, Evaluation and Treatment of Erectile Dysfunction (ED)
Reissue Effective: 04/27/2016 | Reissue Posted: 04/27/2016

MA09.012a, Full-Body Computerized Tomography (CT) Scan Screening
Reissue Effective: 04/27/2016 | Reissue Posted: 04/27/2016

MA11.083, Orthognathic Surgery
Reissue Effective: 04/27/2016 | Reissue Posted: 04/28/2016


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.
MA08.004d, Coagulation Factors for Hemophilia
Effective: 04/01/2016 | Posted: 04/01/2016

MA08.024a, Mepolizumab (Nucala®)
Effective: 04/01/2016 | Posted: 04/01/2016

MA09.009d, Diagnostic and Therapeutic Radiopharmaceutical Agents
Effective: 04/01/2016 | Posted: 04/01/2016

MA08.077a, Talimogene laherparepvec (Imlygic™)
Effective: 04/01/2016 | Posted: 04/01/2016

MA08.051c, C1 Esterase Inhibitors: Cinryze®, Berinert®, and Ruconest®
Effective: 04/01/2016 | Posted: 04/01/2016

MA11.023c, Hyaluronan Acid Therapies for Osteoarthritis of the Knee
Effective: 04/01/2016 | Posted: 04/01/2016

MA07.058b, Sleep Disorder Testing and Positive Airway Pressure Therapy
Effective: 10/01/2015 | Posted: 04/08/2016

MA00.010f, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Effective: 04/15/2016 | Posted: 04/15/2016


Archived Policies
Independence Blue Cross has determined that it is no longer necessary for the following Medicare Advantage policy to remain active.
MA11.064b, Implantable Miniature Telescope™ (IMT) for the Treatment of End-Stage Age-Related Macular Degeneration (AMD)
Notification: 04/20/2016 | Archive Effective: 05/20/2016 | Posted: 04/20/2016

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










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