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.
MA05.066, Cranial Electrotherapy Stimulation
Notification: 07/12/2019 | Effective: 08/12/2019 | Posted: 07/12/2019
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.
MA08.044d, Eculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™)
Notification: 04/02/2019 | Effective: 07/01/2019 | Posted: 07/01/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA06.019b, Measurement of Serum Antibodies to and Measurement of Serum Levels of Biologics
Notification: 05/31/2019 | Effective: 07/01/2019 | Posted: 07/01/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

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

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

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

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

MA08.018c, Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)
Effective: 07/01/2019 | Posted: 07/01/2019
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.063c, Pertuzumab (Perjeta®)
Effective: 07/01/2019 | Posted: 07/01/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA08.066c, Ado-Trastuzumab Emtansine (Kadcyla®)
Effective: 07/01/2019 | Posted: 07/01/2019
Type of policy change: Medical Necessity Criteria; Medical Coding

MA08.062d, Carfilzomib (Kyprolis™)
Effective: 07/01/2019 | Posted: 07/01/2019
Type of policy change: Medical Necessity Criteria

MA00.003k, Preventive Care Services
Effective: 07/01/2019 | Posted: 07/01/2019

MA00.026f, Always Bundled Procedure Codes
Effective: 07/01/2019 | Posted: 07/08/2019
Type of policy change: Medical Coding

MA00.005r, Experimental/Investigational Services
Effective: 07/01/2019 | Posted: 07/08/2019
Type of policy change: Medical Coding

MA11.105f, Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma
Effective: 07/08/2019 | Posted: 07/08/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.052f, Denosumab (Prolia®, Xgeva®), Romosozumab-aqqg (Evenity™)
Effective: 07/15/2019 | Posted: 07/15/2019
Type of policy change: Medical Necessity Criteria; 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: 07/29/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA05.017b, Home Oxygen Therapy
Reissue Effective: 07/03/2019 | Reissue Posted: 07/03/2019

MA11.091b, Manipulation Under Anesthesia
Reissue Effective: 07/03/2019 | Reissue Posted: 07/03/2019

MA05.014a, Ostomy Supplies
Reissue Effective: 07/03/2019 | Reissue Posted: 07/03/2019

MA07.003d, Photodynamic Therapy Using Verteporfin (Visudyne®)
Reissue Effective: 07/03/2019 | Reissue Posted: 07/03/2019

MA05.005c, Automatic External Cardioverter Defibrillators (Wearable and Nonwearable)
Reissue Effective: 07/17/2019 | Reissue Posted: 07/18/2019

MA08.008c, Total Parenteral Nutrition (TPN) / Intradialytic Parenteral Nutrition (IDPN) / Intraperitoneal Nutrition (IPN)
Reissue Effective: 07/17/2019 | Reissue Posted: 07/18/2019

MA05.011a, Seat Lift Mechanisms
Reissue Effective: 07/31/2019 | Reissue Posted: 07/31/2019

MA11.112, Composite Tissue Allotransplantation of the Hand(s) and Face
Reissue Effective: 07/31/2019 | Reissue Posted: 07/31/2019

MA05.031a, Patient Lifts
Reissue Effective: 07/31/2019 | Reissue Posted: 07/31/2019


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.
MA08.022h, Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®)
Effective: 07/01/2019 | Posted: 07/02/2019

MA08.004o, Coagulation Factors
Effective: 07/01/2019 | Posted: 07/02/2019

MA08.105a, Tagraxofusp-erzs (Elzonris™)
Effective: 07/01/2019 | Posted: 07/02/2019

MA11.008c, Refractive Keratoplasty
Effective: 07/01/2019 | Posted: 07/02/2019

MA08.007o, Medicare Part B vs. Part D Crossover Drugs
Effective: 07/01/2019 | Posted: 07/02/2019

MA00.010u, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Effective: 07/01/2019 | Posted: 07/29/2019

(Not Categorized)
MA00.030n, Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
Effective: 07/01/2019 | Posted: 07/29/2019










Connect with Us        


© 2017 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.