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.
MA09.020d, Radiation Therapy Services
Notification: 06/07/2017 | Effective: 09/01/2017 | Posted: 06/07/2017
Type of policy change: General Description, Guidelines, or Informational Update

MA11.073a, Panniculectomy, Abdominoplasty, Abdominal Lipectomy, and Other Excisions of Redundant Skin
Notification: 06/07/2017 | Effective: 07/07/2017 | Posted: 06/07/2017
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA07.007b, Pulmonary Function Tests
Notification: 06/14/2017 | Effective: 07/14/2017 | Posted: 06/14/2017
Type of policy change: Medical Coding

MA05.053e, Implantable and External Infusion Pumps
Notification: 06/14/2017 | Effective: 07/14/2017 | Posted: 06/14/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

MA05.003c, Speech and Non-Speech Generating Devices
Notification: 06/28/2017 | Effective: 07/28/2017 | Posted: 06/28/2017
Type of policy change: Medical Necessity Criteria

MA05.004b, Pneumatic Compression Therapy Devices
Notification: 06/28/2017 | Effective: 07/28/2017 | Posted: 06/28/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.014c, Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails
Notification: 06/29/2017 | Effective: 09/27/2017 | Posted: 06/29/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA06.025c, Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
Notification: 06/30/2017 (Revised 07/20/2017) | Effective: 08/01/2017 | Posted: 06/30/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA00.031c, X-rays Associated with Fractures in the Office Setting
Notification: 06/30/2017 | Effective: 08/01/2017 | Posted: 06/30/2017
Type of policy change: Coverage and/or Reimbursement Position; General Description, Guidelines, or Informational Update

MA00.033c, Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers
Notification: 06/30/2017 | Effective: 08/01/2017 | Posted: 06/30/2017
Type of policy change: Coverage and/or Reimbursement Position; General Description, Guidelines, or Informational Update

MA00.030h, Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
Notification: 06/30/2017 | Effective: 08/01/2017 | Posted: 06/30/2017
Type of policy change: Coverage and/or Reimbursement Position; General Description, Guidelines, or Informational Update

MA00.045a, Reimbursement for Services Performed by Certified Registered Nurse Practitioners (CRNP)
Notification: 06/30/2017 | Effective: 08/01/2017 | Posted: 06/30/2017
Type of policy change: Coverage and/or Reimbursement Position; General Description, Guidelines, or Informational Update

MA00.007c, Obstetrical Ultrasounds for members enrolled in a Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) product
Notification: 06/30/2017 | Effective: 08/01/2017 | Posted: 06/30/2017
Type of policy change: Coverage and/or Reimbursement Position; General Description, Guidelines, or Informational Update

MA00.010n, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Notification: 06/30/2017 | Effective: 08/01/2017 | Posted: 06/30/2017
Type of policy change: Coverage and/or Reimbursement Position; 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.
MA11.112, Composite Tissue Allotransplantation of the Hand(s) and Face
Notification: 05/03/2017 | Effective: 06/02/2017 | Posted: 06/02/2017
Type of policy change: This is a new policy.

MA07.020, Whole-body Integumentary Photography and Dermatoscopy
Notification: 10/01/2014 | Effective: 01/01/2015 | Posted: 06/22/2017
Type of policy change: This is a new policy.

MA12.009, Cosmetic Procedures
Effective: 07/01/2017 | Posted: 06/30/2017
Type of policy change: This is a new policy.

MA12.008, Medical Necessity
Effective: 07/01/2017 | Posted: 06/30/2017
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.
MA11.019b, Vagus Nerve Stimulation (VNS)
Effective: 06/09/2017 | Posted: 06/12/2017
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.031b, Cetuximab (Erbitux®)
Effective: 06/14/2017 | Posted: 06/14/2017
Type of policy change: Medical Necessity Criteria; Medical Coding

MA11.063a, Photocoagulation of Macular Drusen
Effective: 06/14/2017 | Posted: 06/14/2017
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

MA11.047b, Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and Canthoplasty/Canthopexy
Effective: 06/30/2017 | Posted: 06/30/2017
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.080a, Mentoplasty or Genioplasty
Effective: 06/30/2017 | Posted: 06/30/2017
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA11.083a, Orthognathic Surgery
Effective: 06/30/2017 | Posted: 06/30/2017
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA07.055a, Allergy Immunotherapy
Reissue Effective: 06/12/2017 | Reissue Posted: 06/12/2017

MA08.078b, Sebelipase alfa (Kanuma®)
Reissue Effective: 06/07/2017 | Reissue Posted: 06/12/2017

MA08.036a, Alglucosidase alfa (e.g., Myozyme®, Lumizyme®)
Reissue Effective: 06/07/2017 | Reissue Posted: 06/12/2017

MA08.033a, Agalsidase beta (Fabrazyme®)
Reissue Effective: 06/07/2017 | Reissue Posted: 06/12/2017

MA07.013c, Electrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds
Reissue Effective: 06/15/2017 | Reissue Posted: 06/15/2017

MA07.011a, Topical Oxygenation
Reissue Effective: 06/15/2017 | Reissue Posted: 06/15/2017

MA07.008, Platelet-Rich Plasma (PRPs) for Chronic Non-Healing Wounds and Stem-Cell Therapy for Orthopedic Applications
Reissue Effective: 06/15/2017 | Reissue Posted: 06/15/2017

MA05.012a, Orthopedic Footwear
Reissue Effective: 06/21/2017 | Reissue Posted: 06/21/2017

MA05.020b, Therapeutic Shoes
Reissue Effective: 06/21/2017 | Reissue Posted: 06/21/2017

MA07.046d, Corneal Pachymetry Using Ultrasound
Reissue Effective: 06/21/2017 | Reissue Posted: 06/21/2017

MA05.024a, Lower Limb Prostheses
Reissue Effective: 06/21/2017 | Reissue Posted: 06/21/2017

MA11.011a, Artificial Hearts and Ventricular Assist Devices (VADs)
Reissue Effective: 06/21/2017 | Reissue Posted: 06/21/2017

MA11.072, Application and Removal of Tattoos
Reissue Effective: 06/21/2017 | Reissue Posted: 06/21/2017

MA11.103a, Chemical Peels
Reissue Effective: 06/21/2017 | Reissue Posted: 06/21/2017

MA07.050b, Electromyography (EMG) Studies: Needle EMG, Surface EMG (SEMG)
Reissue Effective: 06/22/2017 | Reissue Posted: 06/22/2017

MA11.109a, Procedures for the Treatment of Acne
Reissue Effective: 06/22/2017 | Reissue Posted: 06/22/2017

MA07.051c, Intraoperative Neurophysiological Testing
Reissue Effective: 06/22/2017 | Reissue Posted: 06/22/2017

MA07.033b, Nerve Conduction Studies (NCS) and Related Electrodiagnostic Studies
Reissue Effective: 06/22/2017 | Reissue Posted: 06/22/2017

MA07.018a, Anorectal Manometry, Electromyography (EMG) of Anorectal or Urethral Sphincters; Biofeedback Training for Perineal Muscles and Anorectal or Urethral Sphincters 
Reissue Effective: 06/22/2017 | Reissue Posted: 06/22/2017


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.
MA00.010m, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Effective: 06/01/2017 | Posted: 06/01/2017

MA06.001d, Apheresis Therapy
Effective: 07/01/2017 | Posted: 06/30/2017

MA08.086a, Nusinersen (Spinraza™)
Effective: 07/01/2017 | Posted: 06/30/2017

MA11.004e, Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)
Effective: 07/01/2017 | Posted: 06/30/2017

MA08.007g, Medicare Part B vs. Part D Crossover Drugs
Effective: 07/01/2017 | Posted: 06/30/2017

MA08.042e, Ustekinumab (Stelara®)
Effective: 07/01/2017 | Posted: 06/30/2017

MA07.025c, Intrauterine Systems (IUSs) (e.g., Mirena®, Skyla®, Liletta®, Kyleena®)
Effective: 07/01/2017 | Posted: 06/30/2017










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