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

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Notifications
The following Independence Blue Cross commercial policies have been posted prior to their effective date.
08.00.75k, Erythropoiesis-Stimulating Agents (ESAs)
Notification: 01/11/2016 | Effective: 02/08/2016 | Posted: 01/11/2016

11.02.01k, Treatment of Varicose Veins of the Lower Extremities and Perforator Vein Incompetence
Notification: 01/11/2016 | Effective: 02/10/2016 | Posted: 01/11/2016
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update


Updated Policies
The following commercial 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.
06.02.06n, Genetic Testing for Inherited Breast Cancer 1 (BRCA1) and Breast Cancer 2 (BRCA2) Mutations
Effective: 01/01/2016 | Posted: 01/04/2016

08.00.73g, Bortezomib (Velcade®)
Notification: 10/07/2015 | Effective: 01/05/2016 | Posted: 01/05/2016
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

07.07.07e, Electrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds
Effective: 01/27/2016 | Posted: 01/27/2016
Type of policy change: General Description, Guidelines, or Informational Update

07.03.08f, Neuropsychological Evaluation/Testing
Effective: 01/27/2016 | Posted: 01/27/2016
Type of policy change: General Description, Guidelines, or Informational Update

08.00.17f, Total Parenteral Nutrition (TPN) / Intradialytic Parenteral Nutrition (IDPN) / Intraperitoneal Parenteral Nutrition (IPN)
Notification: 12/30/2015 | Effective: 01/29/2016 | Posted: 01/29/2016


Reissue Policies
The following commercial policies have been reviewed, and no substantive changes were made.
05.00.58h, Home Oxygen Therapy
Reissue Effective: 12/30/2015 | Reissue Posted: 01/06/2016

01.00.09c, Continuous Local Delivery of Anesthesia to Operative Sites Using an Elastomeric Infusion Pump
Reissue Effective: 01/06/2016 | Reissue Posted: 01/06/2016

02.02.01f, Hospice and Respite Care
Reissue Effective: 01/06/2016 | Reissue Posted: 01/06/2016

06.02.01f, Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Treatment
Reissue Effective: 01/06/2016 | Reissue Posted: 01/07/2016

12.00.03c, Alternative Therapies and Complementary Medicine
Reissue Effective: 01/06/2016 | Reissue Posted: 01/07/2016

11.09.02a, Sex Reassignment Surgery (SRS) for Gender Identity Disorder (GID)
Reissue Effective: 12/30/2015 | Reissue Posted: 01/13/2016

06.02.30c, Pharmacogenetic Testing to Determine Drug Sensitivity
Reissue Effective: 12/30/2015 | Reissue Posted: 01/12/2016

06.02.26b, In Vitro Allergy Testing
Reissue Effective: 12/30/2015 | Reissue Posted: 01/12/2016

11.08.23h, Mohs' Micrographic Surgery
Reissue Effective: 12/30/2015 | Reissue Posted: 01/13/2016

11.03.12l, Colorectal Cancer Screening
Reissue Effective: 12/30/2015 | Reissue Posted: 01/13/2016

07.00.05f, In Vivo Allergy Sensitivity Testing
Reissue Effective: 12/30/2015 | Reissue Posted: 01/12/2016

11.03.02p, Bariatric Surgery
Reissue Effective: 12/30/2015 | Reissue Posted: 01/13/2016

11.05.02g, Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and Canthoplasty/Canthopexy
Reissue Effective: 12/30/2015 | Reissue Posted: 01/13/2016

06.02.35h, Genetic Testing
Reissue Effective: 12/30/2015 | Reissue Posted: 01/12/2016

11.07.01n, Hematopoietic Stem Cell Transplantation (Bone Marrow Transplant)
Reissue Effective: 12/30/2015 | Reissue Posted: 01/13/2016

05.00.08d, Continuous Passive Motion (CPM) Devices in the Home Setting
Reissue Effective: 01/20/2016 | Reissue Posted: 01/20/2016

05.00.38i, Negative-Pressure Wound Therapy (NPWT) Systems
Reissue Effective: 01/20/2016 | Reissue Posted: 01/20/2016

07.03.15c, Evaluation and Management (E&M) of Diabetic Peripheral Neuropathy with Loss of Protective Sensation (LOPS)
Reissue Effective: 01/20/2016 | Reissue Posted: 01/21/2016

07.10.05f, Noncontraceptive Use of the Levonorgestrel-Releasing Intrauterine System
Reissue Effective: 01/21/2016 | Reissue Posted: 01/21/2016

11.06.04i, Uterine Artery Embolization
Reissue Effective: 01/21/2016 | Reissue Posted: 01/21/2016

09.00.36h, First-Trimester Prenatal Screening for Fetal Aneuploidy
Reissue Effective: 01/21/2016 | Reissue Posted: 01/21/2016

11.06.07c, Ovarian and Internal Iliac Vein Embolization as Treatment for Pelvic Congestion Syndrome
Reissue Effective: 01/21/2016 | Reissue Posted: 01/21/2016

07.07.01j, Routine Foot Care For Certain Medical Conditions
Reissue Effective: 01/21/2016 | Reissue Posted: 01/21/2016

11.08.17f, Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails
Reissue Effective: 01/21/2016 | Reissue Posted: 01/21/2016
Type of policy change: Medical Coding


Coding Update
The following commercial 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.
11.03.12l, Colorectal Cancer Screening
Effective: 01/01/2016 | Posted: 01/04/2016

06.02.38b, Nerve Fiber Density Testing
Effective: 01/01/2016 | Posted: 01/04/2016

06.02.27h, Assays of Genetic Expression in Tumor Tissue for Breast Cancer Prognosis
Effective: 01/01/2016 | Posted: 01/04/2016

06.02.17e, Serodiagnosis of Inflammatory Bowel Disease (IBD) and the Prometheus® IBD sgi Diagnostic™ Test
Effective: 01/01/2016 | Posted: 01/04/2016

06.02.49a, VeriStrat® Testing for Targeted Therapy in Non-Small-Cell Lung Cancer
Effective: 01/01/2016 | Posted: 01/04/2016

11.03.02p, Bariatric Surgery
Effective: 01/01/2015 | Posted: 01/04/2016

06.02.14g, In Vitro Chemosensitivity and Chemoresistance Assays
Effective: 01/01/2016 | Posted: 01/05/2016

06.02.32c, Multigene Expression Assays for Predicting Recurrence in Colon Cancer
Effective: 01/01/2016 | Posted: 01/05/2016

06.02.29b, AlloMap™ Molecular Expression Testing for Heart Transplant Rejection
Effective: 01/01/2016 | Posted: 01/05/2016

06.02.18j, Pharmacogenetics and Metabolite Monitoring for Using Azathioprine (AZA)/6-Mercaptopurine (6-MP) Therapy
Effective: 01/01/2016 | Posted: 01/05/2016

06.02.10o, Genetic Testing for Inherited Susceptibility to Colon Cancer and Microsatellite Instability Testing (Familial Adenomatous Polyposis and Lynch Syndrome)
Effective: 01/01/2016 | Posted: 01/06/2016

06.02.44a, Presumptive and Definitive Drug Testing
Effective: 01/01/2016 | Posted: 01/08/2016

00.10.39f, Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
Effective: 01/01/2016 | Posted: 01/15/2016

05.00.21p, Durable Medical Equipment (DME)
Effective: 01/01/2016 | Posted: 01/22/2016

00.01.25ac, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Effective: 01/01/2016 | Posted: 01/25/2016

00.03.07n, Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
Effective: 01/01/2016 | Posted: 01/25/2016


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