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
 
                                                                                                        

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.
MA11.030c, Reconstructive Breast Surgery
Effective: 06/03/2019 | Posted: 06/03/2019
Type of policy change: Medical Necessity Criteria; Medical Coding

MA08.012b, Off-label Coverage for Prescription Drugs and/or Biologics
Effective: 06/03/2019 | Posted: 06/03/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA08.036c, Alglucosidase alfa (e.g., Lumizyme®)
Notification: 03/05/2019 | Effective: 06/03/2019 | Posted: 06/03/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA08.089c, Cerliponase alfa (Brineura®)
Notification: 03/05/2019 | Effective: 06/03/2019 | Posted: 06/03/2019
Type of policy change: Medical Necessity Criteria

MA08.034d, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase®, Vimizim®, Naglazyme®, Mepsevii™, etc.)
Notification: 03/05/2019 | Effective: 06/03/2019 | Posted: 06/03/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA08.023b, Enzyme Replacement for the Treatment of Gaucher's Disease
Notification: 03/05/2019 | Effective: 06/03/2019 | Posted: 06/03/2019
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.033b, Agalsidase beta (Fabrazyme®)
Notification: 03/05/2019 | Effective: 06/03/2019 | Posted: 06/03/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA06.007c, Loss-of-Heterozygosity-Based Topographic Genotyping with PathFinderTG®
Notification: 05/17/2019 | Effective: 06/17/2019 | Posted: 06/17/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.022g, Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®)
Notification: 03/19/2019 | Effective: 06/17/2019 | Posted: 06/17/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA05.020f, Therapeutic Shoes
Effective: 06/17/2019 | Posted: 06/17/2019
Type of policy change: General Description, Guidelines, or Informational Update

MA08.055e, Histone Deacetylase Inhibitors for Peripheral T-cell Lymphoma (e.g., Istodax®, Beleodaq®)
Effective: 06/17/2019 | Posted: 06/17/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA08.009g, Immune Globulin: Intravenous (IVIG), Subcutaneous (SCIG)
Effective: 06/17/2019 | Posted: 06/17/2019
Type of policy change: Medical Necessity Criteria; Medical Coding

MA11.100d, Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis
Effective: 06/17/2019 | Posted: 06/17/2019
Type of policy change: Coverage and/or Reimbursement Position

MA06.025i, Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
Notification: 05/17/2019 | Effective: 06/17/2019 | Posted: 06/17/2019
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.072d, Bevacizumab (Avastin®) and Related Biosimilars
Effective: 06/17/2019 | Posted: 06/17/2019
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.043d, Pralatrexate (Folotyn®) for Injection
Effective: 06/17/2019 | Posted: 06/17/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA07.058g, Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies
Notification: 04/30/2019 | Effective: 06/29/2019 | Posted: 06/28/2019
Type of policy change: General Description, Guidelines, or Informational Update


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA05.023a, Wheelchair Cushions and Seating
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA05.032, Power Wheelchairs (PWCs), Power-Operated Vehicles (POVs), and Push-Rim Activated Power-Assist Devices
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA05.046d, Wheelchair Options and Accessories
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA05.021a, Injectable Dermal Fillers
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA05.009, Cervical Traction Devices for In-home Use
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA06.006d, Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Treatment
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA07.008a, Platelet-Rich Plasma (PRPs) for Chronic Non-Healing Wounds and Stem-Cell Therapy for Orthopedic Applications
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA05.012a, Orthopedic Footwear
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA07.011a, Topical Oxygenation
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA05.026a, Manual Wheelchairs
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA11.087b, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA11.088b, Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA11.025, Percutaneous Intradiscal Annuloplasty (IDET/PIRFT)
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA11.069b, Reduction Mammoplasty
Reissue Effective: 06/06/2019 | Reissue Posted: 06/06/2019

MA11.022a, Cryosurgical Ablation of the Prostate Gland
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA11.017e, Trigger Point Injections
Reissue Effective: 06/06/2019 | Reissue Posted: 06/06/2019

MA11.073c, Panniculectomy, Abdominoplasty, Abdominal Lipectomy, and Other Excisions of Redundant Skin
Reissue Effective: 06/06/2019 | Reissue Posted: 06/06/2019

MA11.067d, Labiaplasty
Reissue Effective: 06/06/2019 | Reissue Posted: 06/06/2019

MA11.049c, Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA11.110, Surgery for Gynecomastia
Reissue Effective: 06/06/2019 | Reissue Posted: 06/06/2019

MA11.096b, Percutaneous Discectomy
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA11.016a, Prostate Mapping Biopsy
Reissue Effective: 06/05/2019 | Reissue Posted: 06/06/2019

MA05.034, Tracheostomy Care Supplies
Reissue Effective: 06/19/2019 | Reissue Posted: 06/19/2019

MA05.055, Standing Frames
Reissue Effective: 06/19/2019 | Reissue Posted: 06/19/2019










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