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.
MA03.018, Modifier 53: Discontinued Procedure
Notification: 07/01/2016 | Effective: 10/01/2016 | Posted: 07/01/2016
Type of policy change: This is a new policy.

MA00.005g, Experimental/Investigational Services
Notification: 07/01/2016 (revised 8/31/2016) | Effective: 10/01/2016 | Posted: 07/01/2016
Type of policy change: Coverage and/or Reimbursement Position

MA05.042a, Pulse Oximeters in the Home Setting
Notification: 07/01/2016 | Effective: 08/01/2016 | Posted: 07/01/2016
Type of policy change: Coverage and/or Reimbursement Position

MA00.026b, Always Bundled Procedure Codes
Notification: 07/01/2016 | Effective: 10/01/2016 | Posted: 07/01/2016
Type of policy change: Medical Coding

MA07.005a, Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices
Notification: 07/01/2016 | Effective: 08/01/2016 | Posted: 07/01/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.004e, Coagulation Factors
Notification: 07/08/2016 | Effective: 08/08/2016 | Posted: 07/08/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA10.003a, Physical Medicine & Rehabilitation Services: Physical Therapy (PT) and Occupational Therapy (OT)
Notification: 07/14/2016 | Effective: 10/12/2016 | Posted: 07/14/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA05.043a, Mechanical Stretching Devices for the Treatment of Joint Stiffness or Contractures
Notification: 07/27/2016 | Effective: 08/26/2016 | Posted: 07/27/2016


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.
MA07.023, Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
Notification: 04/06/2016 | Effective: 07/05/2016 | Posted: 07/05/2016
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.
MA05.017a, Home Oxygen Therapy
Notification: 06/01/2016 | Effective: 07/01/2016 | Posted: 07/01/2016
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA05.044b, Durable Medical Equipment (DME)
Notification: 06/01/2016 | Effective: 07/01/2016 | Posted: 07/01/2016

MA05.028c, Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum
Notification: 05/31/2016 | Effective: 07/01/2016 | Posted: 07/01/2016

MA07.051b, Intraoperative Neurophysiological Testing
Effective: 07/01/2016 | Posted: 07/01/2016
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA05.057a, Upper Limb Prostheses
Notification: 06/01/2016 | Effective: 07/01/2016 | Posted: 07/01/2016
Type of policy change: Coverage and/or Reimbursement Position

MA06.014c, Pharmacogenetics and Metabolite Monitoring for Using Azathioprine (AZA)/6-Mercaptopurine (6-MP) Therapy
Effective: 07/01/2016 | Posted: 07/01/2016
Type of policy change: Medical Coding

MA06.008b, Pharmacogenetic Testing to Determine Drug Sensitivity
Effective: 07/01/2016 | Posted: 07/01/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA06.017d, Molecular Diagnostics
Effective: 07/01/2016 | Posted: 07/01/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding

MA08.059b, Ipilimumab (Yervoy®)
Effective: 07/05/2016 | Posted: 07/05/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA05.002b, Hospital Beds and Accessories
Effective: 07/13/2016 | Posted: 07/13/2016

MA11.036b, Surgical Treatment of Nails
Effective: 07/13/2016 | Posted: 07/13/2016

MA07.029a, Refractive Lenses
Effective: 07/20/2016 | Posted: 07/20/2016
Type of policy change: Coverage and/or Reimbursement Position; 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.
MA06.012b, Genetic Testing for Inherited Susceptibility to Colon Cancer and Microsatellite Instability Testing (Familial Adenomatous Polyposis and Lynch Syndrome)
Reissue Effective: 07/01/2016 | Reissue Posted: 07/01/2016

MA06.007a, Loss-of-Heterozygosity-Based Topographic Genotyping with PathFinderTG®
Reissue Effective: 07/01/2016 | Reissue Posted: 07/01/2016

MA06.010a, Genetic Testing for Inherited Breast Cancer 1 (BRCA1) and Breast Cancer 2 (BRCA2) Mutations
Reissue Effective: 07/01/2016 | Reissue Posted: 07/01/2016

MA11.016, Prostate Mapping Biopsy
Reissue Effective: 07/06/2016 | Reissue Posted: 07/06/2016

MA11.058, Otoplasty
Reissue Effective: 07/06/2016 | Reissue Posted: 07/06/2016

MA11.022a, Cryosurgical Ablation of the Prostate Gland
Reissue Effective: 07/06/2016 | Reissue Posted: 07/06/2016

MA11.006a, Bronchial Thermoplasty
Reissue Effective: 07/06/2016 | Reissue Posted: 07/06/2016

MA07.035a, Repetitive Transcranial Magnetic Stimulation (rTMS)
Reissue Effective: 07/06/2016 | Reissue Posted: 07/06/2016

MA05.037, Walkers
Reissue Effective: 07/06/2016 | Reissue Posted: 07/06/2016


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.
MA00.005f, Experimental/Investigational Services
Effective: 07/01/2016 | Posted: 07/01/2016

MA09.009e, Diagnostic and Therapeutic Radiopharmaceutical Agents
Effective: 07/01/2016 | Posted: 07/01/2016










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