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.
09.00.49j, Proton Beam Radiation Therapy
Notification: 07/03/2018 | Effective: 10/01/2018 | Posted: 07/03/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

08.01.21c, Blinatumomab (Blincyto®)
Notification: 07/10/2018 | Effective: 10/08/2018 | Posted: 07/10/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

08.01.47, Triamcinolone Acetonide Extended-Release Injectable (Zilretta™)
Notification: 07/20/2018 (Revised 08/13/2018) | Effective: 08/20/2018 | Posted: 07/20/2018
Type of policy change: This is a new policy.

11.05.16g, Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma
Notification: 07/25/2018 | Effective: 10/22/2018 | Posted: 07/25/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update


New Policies
The following commercial 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
08.01.46, ibalizumab-uiyk (Trogarzo™)
Effective: 07/02/2018 | Posted: 07/02/2018
Type of policy change: This is a new policy.

08.01.48, Tildrakizumab-asmn (Ilumya™)
Effective: 07/16/2018 | Posted: 07/16/2018
Type of policy change: This is a new policy.


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.
00.06.02v, Preventive Care Services (Independence)
Effective: 07/01/2018 | Posted: 07/02/2018
Type of policy change: Medical Necessity Criteria

09.00.49i, Proton Beam Radiation Therapy
Effective: 07/02/2018 | Posted: 07/02/2018
Type of policy change: General Description, Guidelines, or Informational Update

11.15.01t, Spinal Cord and Dorsal Root Ganglion Stimulation
Effective: 07/02/2018 | Posted: 07/02/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding

05.00.26g, Home Prothrombin Time Monitoring
Notification: 04/03/2018 | Effective: 07/02/2018 | Posted: 07/02/2018
Type of policy change: Medical Coding

06.02.52j, eviCore Lab Management Program (Independence)
Notification: 06/01/2018 | Effective: 07/02/2018 | Posted: 07/02/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

11.14.10p, Percutaneous Vertebroplasty, Kyphoplasty, and Sacroplasty
Effective: 07/02/2018 | Posted: 07/02/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding

11.03.12o, Colorectal Cancer Screening
Effective: 07/01/2018 | Posted: 07/02/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

07.07.01n, Routine Foot Care for Certain Medical Conditions
Effective: 07/02/2018 | Posted: 07/02/2018
Type of policy change: Medical Necessity Criteria; Medical Coding

11.08.17h, Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails
Effective: 07/02/2018 | Posted: 07/02/2018
Type of policy change: Medical Necessity Criteria; Medical Coding

12.01.01ao, Experimental/Investigational Services
Effective: 07/01/2018 | Posted: 07/02/2018
Type of policy change: Medical Coding

11.15.09k, Denervation of the Spinal Nerves for Chronic Pain
Effective: 07/02/2018 | Posted: 07/02/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding

08.00.73j, Bortezomib (Bortezomib for Injection, Velcade®)
Notification: 06/08/2018 | Effective: 07/09/2018 | Posted: 07/09/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

08.00.62i, Abatacept (Orencia®) for Injection for Intravenous Use
Effective: 07/20/2018 | Posted: 07/20/2018
Type of policy change: Medical Necessity Criteria

12.01.01ap, Experimental/Investigational Services
Effective: 07/23/2018 | Posted: 07/23/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding

07.03.09n, Electromyography (EMG) Studies: Needle EMG, Surface EMG (SEMG)
Effective: 07/23/2018 | Posted: 07/23/2018
Type of policy change: Medical Coding

07.03.18m, Nerve Conduction Studies (NCS) and Related Electrodiagnostic Studies
Effective: 07/23/2018 | Posted: 07/23/2018
Type of policy change: Medical Coding

07.03.14n, Intraoperative Neurophysiological Monitoring (INM)
Effective: 07/23/2018 | Posted: 07/23/2018
Type of policy change: Medical Coding

07.07.05b, Photography, Including Documentation and Record-Keeping Photography, Whole Body Integumentary Photography, Dermoscopy, and Dermatoscopy
Effective: 07/30/2018 | Posted: 07/30/2018
Type of policy change: General Description, Guidelines, or Informational Update

07.02.21a, Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring
Effective: 07/30/2018 | Posted: 07/30/2018
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

08.01.43c, Chimeric Antigen Receptor (CAR) Therapy
Effective: 07/30/2018 | Posted: 07/30/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

11.15.03j, Insertion of Implantable Infusion Pumps
Notification: 06/27/2018 | Effective: 07/30/2018 | Posted: 07/30/2018
Type of policy change: Medical Necessity Criteria


Reissue Policies
The following commercial policies have been reviewed, and no substantive changes were made.
11.11.06h, Saturation Needle Biopsy of the Prostate
Reissue Effective: 07/03/2018 | Reissue Posted: 07/03/2018

07.13.11h, Contact Lenses for the Treatment of Persistent (Corneal) Epithelial Defects
Reissue Effective: 07/03/2018 | Reissue Posted: 07/03/2018

05.00.37f, Compression Garments
Reissue Effective: 07/03/2018 | Reissue Posted: 07/03/2018

02.01.02c, Private Duty Nursing
Reissue Effective: 07/03/2018 | Reissue Posted: 07/03/2018

08.01.38b, Ocrelizumab (Ocrevus™)
Reissue Effective: 07/03/2018 | Reissue Posted: 07/05/2018

07.05.08a, Fecal Microbiota Transplantation (FMT)
Reissue Effective: 07/18/2018 | Reissue Posted: 07/18/2018

11.04.01c, Islet Cell Transplantation
Reissue Effective: 07/18/2018 | Reissue Posted: 07/18/2018

11.03.15h, Gastric Electrical Stimulation (Enterra™), Gastric Pacing
Reissue Effective: 07/18/2018 | Reissue Posted: 07/18/2018

11.01.06d, Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids
Reissue Effective: 07/18/2018 | Reissue Posted: 07/18/2018


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.
06.02.35r, Genetic Testing (Independence Administrators)
Effective: 07/01/2018 | Posted: 07/03/2018

06.02.44f, Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
Effective: 07/01/2018 | Posted: 07/03/2018


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