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.
MA11.004f, Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)
Notification: 09/03/2019 | Effective: 12/02/2019 | Posted: 09/03/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.017d, Botulinum Toxin Agents
Notification: 09/18/2019 (Revised 10/09/2019) | Effective: 12/16/2019 | Posted: 09/18/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update


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.
MA11.046b, Hair Transplants and Cranial Prostheses (Wigs)
Effective: 09/09/2019 | Posted: 09/09/2019
Type of policy change: General Description, Guidelines, or Informational Update

MA11.002h, Hematopoietic Stem Cell Transplantation
Effective: 09/23/2019 | Posted: 09/23/2019
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA08.088c, Ocrelizumab (Ocrevus®)
Effective: 09/23/2019 | Posted: 09/23/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

MA00.045d, Incident To and Non-Incident To Services Performed by Certified Registered Nurse Practitioners (CRNPs) and Physician Assistants (PAs)
Effective: 09/23/2019 | Posted: 09/23/2019
Type of policy change: General Description, Guidelines, or Informational Update

MA07.036c, Low-Level Laser Therapy
Effective: 09/30/2019 | Posted: 09/30/2019
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.
MA11.033b, Solid Organ Transplantation and Procurement Cost of Organs and Tissues
Reissue Effective: 09/12/2019 | Reissue Posted: 09/12/2019

MA05.042a, Pulse Oximeters in the Home Setting
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

MA05.010d, Ankle-Foot/Knee-Ankle-Foot Orthoses
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

MA07.043a, Smell and Taste Dysfunction Testing
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

MA07.014, Magnetic Pelvic Floor Stimulation (MPFS)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

MA07.010a, Biofeedback Therapy
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

MA08.054b, Cabazitaxel (Jevtana®)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

MA08.053a, Personalized Vaccines (e.g., Provenge®)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

MA08.026e, Treatments for Complex Regional Pain Syndrome (CRPS)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

MA08.011d, Erythropoiesis Stimulating Agents (ESAs)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

MA08.042g, Ustekinumab (Stelara®)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

MA08.094c, Voretigene Neparvovec-rzyl (Luxturna™)
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA08.099a, Burosumab-twza (Crysvita®)
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA08.100a, Patisiran (Onpattro™)
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA08.078c, Sebelipase alfa (Kanuma®)
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA08.097a, Triamcinolone Acetonide Extended-Release Injectable (Zilretta™)
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA10.002b, Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA11.018c, Mohs' Micrographic Surgery (MMS)
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA11.048c, Lumbar Interspinous Process Decompression System
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA11.039c, Cochlear Implantation
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA11.050, Treatment of Medical and Surgical Complications
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA11.058a, Otoplasty Otoplasty or Non-Surgical External Ear Molding
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA11.101, Nucleoplasty
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA11.095a, Lysis of Epidural Adhesions
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA11.083a, Orthognathic Surgery
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA11.109a, Procedures for the Treatment of Acne
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

MA11.080a, Mentoplasty or Genioplasty
Reissue Effective: 09/25/2019 | Reissue Posted: 09/27/2019

MA11.103a, Chemical Peels
Reissue Effective: 09/25/2019 | Reissue Posted: 09/27/2019

MA11.107b, Implantable Steroid-Eluting Sinus Stents
Reissue Effective: 09/25/2019 | Reissue Posted: 09/27/2019

MA11.072, Application and Removal of Tattoos
Reissue Effective: 09/25/2019 | Reissue Posted: 09/27/2019

MA05.065, Transtympanic Micropressure Device as a Treatment of Meniere Disease
Reissue Effective: 09/25/2019 | Reissue Posted: 09/27/2019

MA07.031, Laboratory-Based Vestibular Function Testing
Reissue Effective: 09/25/2019 | Reissue Posted: 09/27/2019

MA11.021a, Non-Surgical Spinal Decompression Therapy
Reissue Effective: 09/25/2019 | Reissue Posted: 09/27/2019

MA11.071a, Selective Photothermolysis Using Pulsed-Dye Lasers (PDL)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/27/2019


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.
MA06.013c, Serodiagnosis of Inflammatory Bowel Disease (IBD) and the Prometheus® IBD sgi Diagnostic™ Test
Effective: 07/01/2019 | Posted: 09/10/2019

MA06.025j, Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
Effective: 07/01/2019 | Posted: 09/10/2019

MA06.017p, Molecular Diagnostics
Effective: 07/01/2019 | Posted: 09/10/2019

MA08.104a, Emapalumab-lzsg (Gamifant®)
Effective: 07/01/2019 | Posted: 09/13/2019










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