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.
MA05.016d, Home Prothrombin Time Monitoring
Notification: 04/03/2018 | Effective: 07/02/2018 | Posted: 04/03/2018
Type of policy change: Medical Coding

MA07.003d, Photodynamic Therapy Using Verteporfin (Visudyne®)
Notification: 04/04/2018 | Effective: 05/07/2018 | Posted: 04/04/2018
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

MA05.006c, Transcutaneous Electrical Nerve Stimulators (TENS) and Associated Supplies
Notification: 04/04/2018 | Effective: 05/07/2018 | Posted: 04/04/2018
Type of policy change: Medical Coding

MA05.013c, Knee Orthoses
Notification: 04/06/2018 | Effective: 05/07/2018 | Posted: 04/06/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA06.006d, Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Treatment
Notification: 04/18/2018 | Effective: 05/21/2018 | Posted: 04/18/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

MA11.048c, Lumbar Interspinous Process Decompression System
Notification: 04/18/2018 | Effective: 05/21/2018 | Posted: 04/18/2018


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.
MA07.053, Nonemergent Inpatient Video Electroencephalogram (EEG) Monitoring and Ambulatory EEG Monitoring in the Home
Notification: 03/30/2018 | Effective: 04/30/2018 | Posted: 04/30/2018
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.
MA00.005m, Experimental/Investigational Services
Notification: 01/02/2018 | Effective: 04/01/2018 | Posted: 04/02/2018
Type of policy change: Medical Coding

MA00.010s, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Notification: 01/03/2018 | Effective: 04/01/2018 | Posted: 04/02/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding

MA07.046e, Corneal Pachymetry Using Ultrasound
Effective: 04/02/2018 | Posted: 04/02/2018
Type of policy change: Medical Coding

MA08.024d, Interleukin-5 (IL-5) Antagonist (e.g., Cinqair®, Nucala®) and IL-5 Receptor Antagonist (e.g., Fasenra™)
Effective: 04/09/2018 | Posted: 04/09/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.077c, Talimogene laherparepvec (Imlygic™)
Effective: 04/09/2018 | Posted: 04/09/2018
Type of policy change: Medical Necessity Criteria

MA11.052b, Radiofrequency Ablation and Cryosurgical Ablation of Lung Tumors
Effective: 04/09/2018 | Posted: 04/09/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.023g, Hyaluronan Acid Therapies for Osteoarthritis of the Knee
Effective: 04/09/2018 | Posted: 04/09/2018
Type of policy change: Medical Necessity Criteria

MA08.086c, Nusinersen (Spinraza™)
Effective: 04/23/2018 | Posted: 04/23/2018
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.066b, Ovarian and Internal Iliac Vein Embolization as Treatment for Pelvic Congestion Syndrome
Effective: 04/23/2018 | Posted: 04/23/2018
Type of policy change: General Description, Guidelines, or Informational Update

MA08.028c, Abatacept (Orencia®) for Injection for Intravenous Use
Effective: 04/23/2018 | Posted: 04/23/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA07.021b, Partial Coherence Interferometry
Effective: 04/23/2018 | Posted: 04/23/2018
Type of policy change: Medical Coding

MA11.091b, Manipulation Under Anesthesia
Effective: 04/30/2018 | Posted: 04/30/2018
Type of policy change: Medical Coding

MA00.006d, Care Management and Care Planning Services
Effective: 04/30/2018 | Posted: 04/30/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA05.035a, Cold Therapy Devices
Reissue Effective: 04/11/2018 | Reissue Posted: 04/12/2018

MA05.022, Home-Use Light Box for the Treatment of Seasonal Affective Disorder (SAD)
Reissue Effective: 04/11/2018 | Reissue Posted: 04/12/2018

MA08.085, Asparaginase Erwinia Chrysanthemi (Erwinaze®)
Reissue Effective: 04/11/2018 | Reissue Posted: 04/12/2018

MA07.060, Oral and Maxillofacial Prosthesis
Reissue Effective: 04/11//2018 | Reissue Posted: 04/12/2018

MA11.097b, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis
Reissue Effective: 04/11/2018 | Reissue Posted: 04/12/2018

MA11.045b, Uterine Artery Embolization
Reissue Effective: 04/11/2018 | Reissue Posted: 04/12/2018

MA11.087b, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
Reissue Effective: 04/11/2018 | Reissue Posted: 04/12/2018

MA05.005c, Automatic External Cardioverter Defibrillators (Wearable and Nonwearable)
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA05.011a, Seat Lift Mechanisms
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA00.002f, Continuous Glucose Monitors and Artificial Pancreas Device Systems (APDS)
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA05.015c, Home Blood Glucose Monitors and Supplies
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA05.017a, Home Oxygen Therapy
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA05.036b, Commode Chairs
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA11.088b, Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA08.074, Deoxycholic Acid (Kybella™)
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA11.011b, Artificial Hearts and Ventricular Assist Devices (VADs)
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA11.110, Surgery for Gynecomastia
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA05.042a, Pulse Oximeters in the Home Setting
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA11.076c, Removal of Breast Implants
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA05.059, Electrical Continence Aid
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA05.065, Transtympanic Micropressure Device as a Treatment of Meniere Disease
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA11.021a, Non-Surgical Spinal Decompression Therapy
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA08.029a, Natalizumab (Tysabri®)
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA11.093a, Surgical Treatments of Athletic Pubalgia
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA05.054d, Urological Supplies
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA05.037, Walkers
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA05.031a, Patient Lifts
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA11.112, Composite Tissue Allotransplantation of the Hand(s) and Face
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA12.008, Medical Necessity
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA11.036c, Surgical Treatment of Nails
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA11.098, Migraine Deactivation Surgery
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018

MA05.050a, Eye Prostheses and Scleral Cover Shell
Reissue Effective: 04/25/2018 | Reissue Posted: 04/25/2018


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.
MA06.031b, Vitamin D Assay Testing
Effective: 04/01/2018 | Posted: 04/02/2018

MA06.017l, Molecular Diagnostics
Effective: 04/01/2018 | Posted: 04/03/2018


Archived Policies
Independence Blue Cross has determined that it is no longer necessary for the following Medicare Advantage policy to remain active.
MA07.045a, Microvolt T-Wave Alternans (MTWA)
Notification: 04/06/2018 | Archive Effective: 05/07/2018 | Posted: 04/06/2018










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