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.
MA09.020i, Radiation Therapy Services
Notification: 04/01/2019 | Effective: 07/01/2019 | Posted: 04/01/2019
Type of policy change: General Description, Guidelines, or Informational Update

MA09.002i, High-Technology Radiology Services
Notification: 04/01/2019 | Effective: 07/01/2019 | Posted: 04/01/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria

MA11.113a, Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound
Notification: 04/01/2019 | Effective: 05/01/2019 | Posted: 04/01/2019
Type of policy change: Medical Coding

MA11.113b, Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound
Notification: 04/01/2019 | Effective: 07/01/2019 | Posted: 04/01/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria

MA07.056d, Photodynamic Therapy (PDT) Using Levulan® Kerastick® or Ameluz® (Aminolevulinic Acid HCl [ALA])
Notification: 04/02/2019 | Effective: 07/01/2019 | Posted: 04/02/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.044d, Eculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™).
Notification: 04/02/2019 (Revised 06/18/2019) | Effective: 07/01/2019 | Posted: 04/02/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA08.016d, Treatment of Pulmonary Artery Hypertension with Intravenous, Subcutaneous, and Inhaled Pharmacologic Agents
Notification: 04/08/2019 | Effective: 05/06/2019 | Posted: 04/08/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA06.032, Cobalamin (Vitamin B12), Folic Acid, and Homocysteine Testing
Notification: 04/29/2019 | Effective: 05/28/2019 | Posted: 04/29/2019
Type of policy change: This is a new policy.

MA07.058g, Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies
Notification: 04/30/2019 | Effective: 06/29/2019 | Posted: 04/30/2019
Type of policy change: General Description, Guidelines, or Informational Update

MA11.015h, Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds
Notification: 04/30/2019 | Effective: 07/29/2019 | Posted: 04/30/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; 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.
MA08.105, Tagraxofusp-erzs (Elzonris™)
Effective: 04/15/2019 | Posted: 04/15/2019
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.
MA11.001h, Treatment of Varicose Veins of the Lower Extremities and Perforator Vein Incompetence
Effective: 04/01/2019 | Posted: 04/01/2019
Type of policy change: Coverage and/or Reimbursement Position; General Description, Guidelines, or Informational Update

MA11.017e, Trigger Point Injections
Notification: 04/01/2019 | Effective: 04/01/2019 | Posted: 04/01/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

MA08.052e, Denosumab (Prolia®, Xgeva®)
Effective: 04/08/2019 | Posted: 04/08/2019
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.106d, Treatment of Gender Dysphoria
Effective: 04/15/2019 | Posted: 04/15/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA05.057c, Upper Limb Prostheses
Effective: 04/15/2019 | Posted: 04/15/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.037f, Bortezomib (Bortezomib for Injection, Velcade®)
Effective: 04/15/2019 | Posted: 04/15/2019
Type of policy change: Medical Necessity Criteria; Medical Coding

MA11.097c, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis
Effective: 04/15/2019 | Posted: 04/15/2019
Type of policy change: Coverage and/or Reimbursement Position; General Description, Guidelines, or Informational Update

MA08.045e, Tocilizumab (Actemra®) for Intravenous Infusion
Effective: 04/22/2019 | Posted: 04/22/2019
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.019f, Infliximab and Related Biosimilars
Effective: 04/22/2019 | Posted: 04/22/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding

MA05.024c, Lower Limb Prostheses
Effective: 04/22/2019 | Posted: 04/22/2019
Type of policy change: Medical Necessity Criteria; Medical Coding

MA08.082a, Pegfilgrastim (Neulasta®) and Related Biosimilars
Effective: 04/22/2019 | Posted: 04/22/2019
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.
MA08.015c, Alemtuzumab (Lemtrada™)
Reissue Effective: 04/10/2019 | Reissue Posted: 04/11/2019

MA11.014d, Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails
Reissue Effective: 04/10/2019 | Reissue Posted: 04/11/2019

MA08.096a, Ibalizumab-uiyk (Trogarzo™)
Reissue Effective: 04/10/2019 | Reissue Posted: 04/11/2019

MA11.010a, Abortion
Reissue Effective: 04/10/2019 | Reissue Posted: 04/11/2019

MA11.077c, Prophylactic Mastectomy, Oophorectomy/Salpingo-Oophorectomy, and Hysterectomy
Reissue Effective: 04/24/2019 | Reissue Posted: 04/25/2019

MA07.038e, Neuropsychological Testing for Neurologically Based Conditions
Reissue Effective: 04/24/2019 | Reissue Posted: 04/25/2019

MA07.024b, Medical and Surgical Treatment of Temporomandibular Joint Disorder
Reissue Effective: 04/25/2019 | Reissue Posted: 04/25/2019

MA07.027b, Autonomic Nervous System Testing
Reissue Effective: 04/25/2019 | Reissue Posted: 04/25/2019

MA11.079c, Evaluation and Treatment of Erectile Dysfunction (ED)
Reissue Effective: 04/25/2019 | Reissue Posted: 04/25/2019


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.
MA08.103a, Moxetumomab pasudotox-tdfk (Lumoxiti™)
Effective: 04/01/2019 | Posted: 04/01/2019

MA08.004n, Coagulation Factors
Effective: 04/01/2019 | Posted: 04/01/2019

MA03.011d, Modifiers 26 (Professional Component) and TC (Technical Component)
Effective: 01/01/2019 | Posted: 04/26/2019










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