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.
11.00.06g, Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring for Adults
Notification: 02/24/2017 | Effective: 03/24/2017 | Posted: 02/24/2017
Type of policy change: 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.
02.02.01g, Hospice Care
Effective: 02/10/2017 | Posted: 02/10/2017
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

05.00.65e, Home Uterine Activity Monitoring (HUAM) Devices
Effective: 02/22/2017 | Posted: 02/22/2017
Type of policy change: General Description, Guidelines, or Informational Update

00.10.37b, Humanitarian Use Devices (HUD) and the Humanitarian Device Exemption (HDE) Process
Effective: 02/22/2017 | Posted: 02/22/2017
Type of policy change: General Description, Guidelines, or Informational Update

07.10.04c, Parenterally Administered Terbutaline Sulfate for the Prevention or Treatment of Pre-Term Labor
Effective: 02/22/2017 | Posted: 02/22/2017
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

05.00.04d, Food and Drug Administration (FDA) Approval of Medical Devices
Effective: 02/22/2017 | Posted: 02/22/2017
Type of policy change: General Description, Guidelines, or Informational Update

11.06.02h, Elective Abortion
Effective: 02/22/2017 | Posted: 02/22/2017
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

09.00.36i, First-Trimester Prenatal Screening for Fetal Aneuploidy Using Fetal Ultrasound Markers
Effective: 02/22/2017 | Posted: 02/22/2017
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update


Reissue Policies
The following commercial policies have been reviewed, and no substantive changes were made.
11.00.14e, Treatment of Twin-Twin Transfusion Syndrome (TTTS)
Reissue Effective: 02/15/2017 | Reissue Posted: 02/16/2017

07.10.06d, Assisted Reproductive Technology for Infertility and Oocyte Cryopreservation
Reissue Effective: 02/15/2017 | Reissue Posted: 02/16/2017

05.00.61f, Cervical Traction Devices for In-home Use
Reissue Effective: 02/15/2017 | Reissue Posted: 02/16/2017

11.00.03i, Fetal Surgery
Reissue Effective: 02/15/2017 | Reissue Posted: 02/16/2017

11.06.05e, Endometrial Ablation
Reissue Effective: 02/15/2017 | Reissue Posted: 02/16/2017

11.06.07c, Ovarian and Internal Iliac Vein Embolization as Treatment for Pelvic Congestion Syndrome
Reissue Effective: 02/15/2017 | Reissue Posted: 02/16/2017

11.01.02l, Cochlear Implant
Reissue Effective: 02/15/2017 | Reissue Posted: 02/16/2017

11.15.09i, Denervation of the Spinal Nerves for Chronic Pain
Reissue Effective: 02/15/2017 | Reissue Posted: 02/16/2017

11.06.04j, Uterine Artery Embolization
Reissue Effective: 02/15/2017 | Reissue Posted: 02/16/2017

11.01.06c, Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids
Reissue Effective: 02/15/2017 | Reissue Posted: 02/16/2017


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.
06.02.35l, Genetic Testing (Independence Administrators)
Effective: 02/01/2017 | Posted: 02/01/2017

06.02.43b, Proteomic (Protein)-Based Testing for the Evaluation of Ovarian (Adnexal) Masses Using OVA1® Test and Risk of Ovarian Malignancy Algorithm (ROMA™)
Effective: 02/01/2017 | Posted: 02/01/2017

06.02.52c, eviCore Lab Management Program (Independence)
Effective: 02/01/2017 | Posted: 02/01/2017

11.03.12n, Colorectal Cancer Screening
Effective: 02/01/2017 | Posted: 02/01/2017

11.00.11i, Use of an Operating Microscope During a Surgical Procedure
Effective: 01/01/2017 | Posted: 02/06/2017

00.10.36n, Radiologic Guidance of a Procedure
Effective: 01/01/2017 | Posted: 02/06/2017

00.03.07p, Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
Effective: 02/01/2017 | Posted: 02/06/2017

00.03.06d, 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: 01/01/2017 (attachments revised 05/10/2017) | Posted: 02/06/2017

00.01.25aj, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Effective: 01/01/2017 | Posted: 02/06/2017


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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.