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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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.
05.00.79a, Insulin Pumps and Long term Interstitial Continuous Glucose Monitoring Systems
Notification: 04/04/2018 | Effective: 05/07/2018 | Posted: 05/07/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

05.00.47n, Knee Orthoses
Notification: 04/06/2018 | Effective: 05/07/2018 | Posted: 05/07/2018
Type of policy change: Coverage and/or Reimbursement Position; General Description, Guidelines, or Informational Update

07.13.05k, Photodynamic Therapy (PDT) Using Verteporfin (Visudyne®)
Notification: 04/04/2018 | Effective: 05/07/2018 | Posted: 05/07/2018
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

05.00.24q, Short-term Interstitial Continuous Glucose Monitoring Systems (CGMSs)
Notification: 04/04/2018 | Effective: 05/07/2018 | Posted: 05/07/2018
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

11.00.03j, Fetal Surgery
Notification: 04/04/2018 | Effective: 05/07/2018 | Posted: 05/07/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

05.00.74c, Transcutaneous Electrical Nerve Stimulators (TENS) and Associated Supplies
Notification: 04/04/2018 | Effective: 05/07/2018 | Posted: 05/07/2018
Type of policy change: Medical Coding

05.00.31e, Pulse Oximetry Devices in the Home Setting
Effective: 05/07/2018 | Posted: 05/07/2018
Type of policy change: Medical Necessity Criteria

07.10.06e, Assisted Reproductive Technology for Infertility and Oocyte Cryopreservation
Effective: 05/07/2018 | Posted: 05/07/2018
Type of policy change: General Description, Guidelines, or Informational Update

00.01.59d, Care Management and Care Planning Services
Effective: 05/07/2018 | Posted: 05/07/2018
Type of policy change: Coverage and/or Reimbursement Position

07.11.01c, Smell and Taste Dysfunction Testing
Effective: 05/07/2018 | Posted: 05/07/2018
Type of policy change: General Description, Guidelines, or Informational Update

11.08.02h, Reduction Mammoplasty
Effective: 05/07/2018 | Posted: 05/07/2018
Type of policy change: Medical Necessity Criteria; Medical Coding

11.06.09d, Labiaplasty
Effective: 05/14/2018 | Posted: 05/14/2018
Type of policy change: General Description, Guidelines, or Informational Update

05.00.58k, Home Oxygen Therapy
Effective: 05/21/2018 | Posted: 05/21/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

06.02.01i, Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Therapy
Notification: 04/18/2018 | Effective: 05/21/2018 | Posted: 05/21/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

08.01.04r, Immunizations
Effective: 05/21/2018 | Posted: 05/21/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

05.00.21s, Durable Medical Equipment (DME) and Consumable Medical Supplies
Notification: 02/21/2018 | Effective: 05/22/2018 | Posted: 05/22/2018
Type of policy change: Medical Coding

08.00.92v, Coagulation Factors
Effective: 05/28/2018 | Posted: 05/25/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

08.00.78y, Self-Administered Drugs
Effective: 05/28/2018 | Posted: 05/25/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update


Reissue Policies
The following commercial policies have been reviewed, and no substantive changes were made.
05.00.56i, Hospital Beds and Accessories
Reissue Effective: 05/09/2018 | Reissue Posted: 05/09/2018

11.02.25f, Transcatheter Cardiac Valve Procedures
Reissue Effective: 05/09/2018 | Reissue Posted: 05/09/2018

11.02.26a, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation
Reissue Effective: 05/09/2018 | Reissue Posted: 05/09/2018

11.02.11g, Transcatheter Closure of Cardiac Septal Defects
Reissue Effective: 05/09/2018 | Reissue Posted: 05/09/2018

09.00.51a, Positron Emission Mammography (PEM)
Reissue Effective: 05/23/2018 | Reissue Posted: 05/23/2018

07.00.09d, Topical Oxygenation
Reissue Effective: 05/23/2018 | Reissue Posted: 05/23/2018

07.12.01e, Pelvic Floor Stimulation as a Treatment of Incontinence
Reissue Effective: 05/23/2018 | Reissue Posted: 05/23/2018

07.03.15d, Evaluation and Management (E&M) of Diabetic Peripheral Neuropathy with Loss of Protective Sensation (LOPS)
Reissue Effective: 05/23/2018 | Reissue Posted: 05/23/2018

11.16.06h, Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis
Reissue Effective: 05/23/2018 | Reissue Posted: 05/23/2018

05.00.50k, Ostomy Supplies
Reissue Effective: 05/23/2018 | Reissue Posted: 05/23/2018


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