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.
MA05.065, Transtympanic Micropressure Device as a Treatment of Meniere Disease
Notification: 09/01/2016 | Effective: 10/01/2016 | Posted: 09/01/2016
Type of policy change: This is a new policy.

MA08.037b, Bortezomib (Velcade®)
Notification: 09/01/2016 | Effective: 10/01/2016 | Posted: 09/01/2016
Type of policy change: Medical Necessity Criteria

MA07.001a, Hyperbaric Oxygen Therapy
Notification: 09/02/2016 | Effective: 12/01/2016 | Posted: 09/02/2016
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA00.009d, Reporting and Documentation Requirements for Anesthesia Services
Notification: 09/02/2016 (revised 09/08/2016) | Effective: 12/01/2016 | Posted: 09/02/2016

MA07.058d, Sleep Disorder Testing and Positive Airway Pressure Therapy
Notification: 09/14/2016 | Effective: 10/14/2016 | Posted: 09/14/2016
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA05.054b, Urological Supplies
Notification: 09/14/2016 | Effective: 10/14/2016 | Posted: 09/14/2016
Type of policy change: Medical Coding

MA07.036b, Low-Level Laser Therapy
Notification: 09/14/2016 | Effective: 10/14/2016 | Posted: 09/14/2016

MA07.017b, Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Notification: 10/01/2016 | Effective: 01/01/2017 | Posted: 09/30/2016
Type of policy change: Medical Coding

MA00.005h, Experimental/Investigational Services
Notification: 09/30/2016 (revised 10/20/2016, 12/22/2016) | Effective: 01/01/2017 | Posted: 09/30/2016

MA08.081, Fulvestrant (Faslodex®)
Notification: 09/30/2016 | Effective: 01/01/2017 | Posted: 09/30/2016
Type of policy change: This is a new policy.

MA08.082, Pegfilgrastim (Neulasta®)
Notification: 09/30/2016 (revised 11/10/2016) | Effective: 01/01/2017 | Posted: 09/30/2016
Type of policy change: This is a new policy.

MA11.091a, Manipulation Under Anesthesia
Notification: 09/30/2016 | Effective: 01/01/2017 | Posted: 09/30/2016
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA09.020c, Radiation Therapy Services (Independence)
Notification: 09/30/2016 | Effective: 01/01/2017 (revised 12/08/2016) | Posted: 09/30/2016
Type of policy change: 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.
MA05.065, Transtympanic Micropressure Device as a Treatment of Meniere Disease
Notification: 09/01/2016 | Effective: 10/01/2016 | Posted: 09/30/2016
Type of policy change: This is a new policy.

MA03.018, Modifier 53: Discontinued Procedure
Notification: 07/01/2016 | Effective: 10/01/2016 | Posted: 09/30/2016
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.
MA11.001b, Treatment of Varicose Veins of the Lower Extremities and Perforator Vein Incompetence
Effective: 09/07/2016 | Posted: 09/07/2016
Type of policy change: Medical Coding

MA11.002c, Hematopoietic Stem Cell Transplantation
Effective: 09/09/2016 | Posted: 09/09/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

MA08.075a, Ramucirumab (Cyramza®)
Effective: 09/21/2106 | Posted: 09/21/2016
Type of policy change: Medical Necessity Criteria

MA08.008c, Total Parenteral Nutrition (TPN) / Intradialytic Parenteral Nutrition (IDPN) / Intraperitoneal Nutrition (IPN)
Effective: 09/21/2016 | Posted: 09/21/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

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

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

MA00.005g, Experimental/Investigational Services
Notification: 07/01/2016 | Effective: 10/01/2016 | Posted: 09/30/2016
Type of policy change: Coverage and/or Reimbursement Position

MA00.026b, Always Bundled Procedure Codes
Notification: 07/01/2016 | Effective: 10/01/2016 | Posted: 09/30/2016
Type of policy change: Medical Coding

MA08.037b, Bortezomib (Velcade®)
Notification: 09/01/2016 | Effective: 10/01/2016 | Posted: 09/30/2016
Type of policy change: Medical Necessity Criteria

MA05.020b, Therapeutic Shoes
Effective: 10/01/2016 | Posted: 09/30/2016
Type of policy change: Medical Coding

MA07.012a, External Counterpulsation (ECP)
Effective: 09/30/2016 | Posted: 09/30/2016
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

MA07.007a, Pulmonary Function Tests
Effective: 10/01/2016 | Posted: 09/30/2016
Type of policy change: Medical Coding

MA11.039b, Cochlear Implantation
Effective: 10/01/2016 | Posted: 09/30/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.045b, Uterine Artery Embolization
Effective: 10/01/2016 | Posted: 09/30/2016
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA11.056b, Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery
Effective: 10/01/2016 | Posted: 09/30/2016
Type of policy change: Medical Necessity Criteria; Medical Coding

MA11.049b, Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids
Effective: 10/01/2016 | Posted: 09/30/2016
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.
MA05.047a, Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults
Reissue Effective: 08/31/2016 | Reissue Posted: 09/01/2016

MA05.027, Subcutaneous Implantable Cardioverter Defibrillator (S-ICD) for Treating Life-threatening Ventricular Tachyarrhythmia
Reissue Effective: 08/31/2016 | Reissue Posted: 09/01/2016

MA10.001, Pulmonary Rehabilitation Services
Reissue Effective: 08/31/2016 | Reissue Posted: 09/01/2016

MA11.003, Lung Volume Reduction Surgery (LVRS)
Reissue Effective: 08/31/2016 | Reissue Posted: 09/01/2016

MA05.012a, Orthopedic Footwear
Reissue Effective: 08/31/2016 | Reissue Posted: 09/01/2016

MA09.020b, Radiation Therapy Services (Independence)
Reissue Effective: 09/02/2016 | Reissue Posted: 09/02/2016

MA02.003a, Home Health Care Services
Reissue Effective: 09/14/2016 | Reissue Posted: 09/15/2016

MA05.032, Power Wheelchairs (PWCs), Power-Operated Vehicles (POVs), and Push-Rim Activated Power-Assist Devices
Reissue Effective: 09/14/2016 | Reissue Posted: 09/15/2016

MA07.026, Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring
Reissue Effective: 09/14/2016 | Reissue Posted: 09/15/2016

MA07.060, Oral and Maxillofacial Prosthesis
Reissue Effective: 09/14/2016 | Reissue Posted: 09/16/2016

MA11.104a, Lacrimal Punctum Plugs
Reissue Effective: 09/14/2016 | Reissue Posted: 09/16/2016

MA08.057a, Belimumab (Benlysta®)
Reissue Effective: 09/28/2016 | Reissue Posted: 09/28/2016

MA05.063a, Repair or Replacement of an External Prosthetic Device
Reissue Effective: 09/28/2016 | Reissue Posted: 09/28/2016


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.
MA00.002b, Continuous Glucose Monitors and Artificial Pancreas Device Systems (APDS)
Effective: 10/01/2016 | Posted: 09/30/2016

MA00.003e, Preventive Care Services
Effective: 10/01/2016 | Posted: 09/30/2016

MA00.039a, Never Events and Preventable Adverse Events
Effective: 10/01/2016 | Posted: 09/30/2016

MA07.003b, Photodynamic Therapy Using Verteporfin (Visudyne®)
Effective: 10/01/2016 | Posted: 09/30/2016

MA05.005a, Automatic External and Wearable Cardioverter Defibrillators
Effective: 10/01/2016 | Posted: 09/30/2016

MA07.023a, Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
Effective: 10/01/2016 | Posted: 09/30/2016

MA07.009c, Routine Foot Care For Certain Medical Conditions
Effective: 10/01/2016 | Posted: 09/30/2016

MA08.068b, Brentuximab Vedotin (Adcetris®)
Effective: 10/01/2016 | Posted: 09/30/2016

MA08.073b, Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists (e.g., ranibizumab [Lucentis®], pegaptanib sodium [Macugen®], aflibercept [Eylea®])
Effective: 10/01/2016 | Posted: 09/30/2016

MA08.041b, Bendamustine Hydrochloride (Treanda®)
Effective: 10/01/2016 | Posted: 09/30/2016

MA05.015a, Home Blood Glucose Monitors and Supplies
Effective: 10/01/2016 | Posted: 09/30/2016

MA07.047b, Pain Management of Peripheral Nerves by Injection
Effective: 10/01/2016 | Posted: 09/30/2016

MA07.033b, Nerve Conduction Studies (NCS) and Related Electrodiagnostic Studies
Effective: 10/01/2016 | Posted: 09/30/2016

MA08.065c, Octreotide Acetate (Sandostatin® LAR Depot)
Effective: 10/01/2016 | Posted: 09/30/2016

MA07.050b, Electromyography (EMG) Studies: Needle EMG, Surface EMG (SEMG)
Effective: 10/01/2016 | Posted: 09/30/2016

MA08.007e, Medicare Part B vs. Part D Crossover Drugs
Effective: 10/01/2016 | Posted: 09/30/2016

MA11.031d, Spinal Cord Stimulation (Dorsal Column Stimulation)
Effective: 10/01/2016 | Posted: 09/30/2016

MA08.022c, Rituximab (Rituxan®)
Effective: 10/01/2016 | Posted: 09/30/2016

MA08.006d, Siltuximab (Sylvant®)
Effective: 10/01/2016 | Posted: 09/30/2016

MA11.079c, Evaluation and Treatment of Erectile Dysfunction (ED)
Effective: 10/01/2016 | Posted: 09/30/2016

MA08.004f, Coagulation Factors
Effective: 10/01/2016 | Posted: 09/30/2016

MA10.004c, Chiropractic Services
Effective: 10/01/2016 | Posted: 09/30/2016

MA10.002a, Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs
Effective: 10/01/2016 | Posted: 09/30/2016

MA07.058c, Sleep Disorder Testing and Positive Airway Pressure Therapy
Effective: 10/01/2016 | Posted: 09/30/2016

MA11.102c, Denervation of the Spinal Nerves for Chronic Pain
Effective: 10/01/2016 | Posted: 09/30/2016

MA09.002d, High-Technology Radiology Services
Effective: 10/01/2016 | Posted: 09/30/2016










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