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.
MA05.053c, Implantable and External Infusion Pumps
Notification: 08/24/2016 | Effective: 09/23/2016 | Posted: 08/24/2016
Type of policy change: Medical Necessity Criteria; Medical Coding

MA08.003b, Enteral Nutritional Therapy
Notification: 08/29/2016 | Effective: 09/28/2016 | Posted: 08/29/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding


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.
MA06.031, Vitamin D Assay Testing
Notification: 05/03/2016 | Effective: 08/01/2016 | Posted: 08/01/2016
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.
MA07.005a, Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices
Notification: 07/01/2016 | Effective: 08/01/2016 | Posted: 08/01/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

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

MA07.050a, Electromyography (EMG) Studies: Needle EMG, Surface EMG (SEMG)
Notification: 06/02/2016 | Effective: 08/01/2016 | Posted: 08/01/2016
Type of policy change: Medical Coding

MA07.033a, Nerve Conduction Studies (NCS) and Related Electrodiagnostic Studies
Notification: 06/02/2016 | Effective: 08/01/2016 | Posted: 08/01/2016
Type of policy change: Medical Coding

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

MA08.052b, Denosumab (Prolia®, Xgeva®)
Effective: 08/10/2016 | Posted: 08/10/2016
Type of policy change: Medical Necessity Criteria; Medical Coding

MA11.011a, Artificial Hearts and Ventricular Assist Devices (VADs)
Effective: 08/12/2016 | Posted: 08/12/2016
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

MA00.029b, Physical Medicine and Rehabilitation Services Eligible for Reimbursement Above Capitation to Physical and Occupational Therapy (PT/OT) Providers for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
Effective: 08/22/2016 | Posted: 08/22/2016
Type of policy change: Coverage and/or Reimbursement Position

MA11.069a, Reduction Mammoplasty
Effective: 08/24/2016 | Posted: 08/24/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.077b, Prophylactic Mastectomy, Oophorectomy/Salpingo-Oophorectomy, and Hysterectomy
Effective: 08/26/2016 | Posted: 08/26/2016
Type of policy change: Coverage and/or Reimbursement Position; 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: 08/26/2016


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA08.015b, Alemtuzumab (Lemtrada™)
Reissue Effective: 08/03/2016 | Reissue Posted: 08/03/2016

MA11.029, Spinal Discectomy
Reissue Effective: 08/03/2016 | Reissue Posted: 08/03/2016

MA11.024b, Percutaneous Vertebroplasty and Percutaneous Vertebral Augmentation
Reissue Effective: 08/03/2016 | Reissue Posted: 08/03/2016

MA11.088b, Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure
Reissue Effective: 08/03/2016 | Reissue Posted: 08/03/2016

MA11.041, Spinal Laminectomy
Reissue Effective: 08/03/2016 | Reissue Posted: 08/03/2016

MA11.093a, Surgical Treatments of Athletic Pubalgia
Reissue Effective: 08/03/2016 | Reissue Posted: 08/03/2016

MA11.090, Surgical Treatment of Femoroacetabular Impingement
Reissue Effective: 08/03/2016 | Reissue Posted: 08/03/2016

MA11.096, Percutaneous Discectomy
Reissue Effective: 08/03/2016 | Reissue Posted: 08/03/2016

MA05.014a, Ostomy Supplies
Reissue Effective: 08/03/2016 | Reissue Posted: 08/04/2016

MA05.023, Wheelchair Cushions and Seating
Reissue Effective: 08/03/2016 | Reissue Posted: 08/04/2016

MA05.026, Manual Wheelchairs
Reissue Effective: 08/03/2016 | Reissue Posted: 08/04/2016

MA05.046a, Wheelchair Options and Accessories
Reissue Effective: 08/03/2016 | Reissue Posted: 08/04/2016

MA11.040a, Transcatheter Closure of Cardiac Septal Defects
Reissue Effective: 08/17/2016 | Reissue Posted: 08/18/2016

MA08.067a, Repository Corticotropin (H.P. Acthar® Gel Injection)
Reissue Effective: 08/17/2016 | Reissue Posted: 08/18/2016

MA00.001, Obsolete or Unreliable Diagnostic Tests and Medical Services
Reissue Effective: 08/17/2016 | Reissue Posted: 08/18/2016

MA11.109, Procedures for the Treatment of Acne
Reissue Effective: 08/17/2016 | Reissue Posted: 08/19/2016

MA05.022, Home-Use Light Box for the Treatment of Seasonal Affective Disorder (SAD)
Reissue Effective: 08/17/2016 | Reissue Posted: 08/19/2016

MA05.024a, Lower Limb Prostheses
Reissue Effective: 08/17/2016 | Reissue Posted: 08/19/2016

MA11.103a, Chemical Peels
Reissue Effective: 08/17/2016 | Reissue Posted: 08/21/2016

MA07.052, Bioimpedance for the Detection of Lymphedema
Reissue Effective: 08/17/2016 | Reissue Posted: 08/21/2016

MA11.061a, Transcoronary Ablation of Septal Hypertrophy (TASH)
Reissue Effective: 08/17/2016 | Reissue Posted: 08/22/2016


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.
MA00.006a, Care Management and Coordination Services
Effective: 07/01/2016 | Posted: 08/10/2016

MA00.010h, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Effective: 08/22/2016 | Posted: 08/22/2016










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