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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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
08.01.22, Alemtuzumab (Lemtrada™)
Notification: 07/29/2015 | Effective: 08/28/2015 | Posted: 08/28/2015

08.01.24, Deoxycholic Acid (Kybella™)
Notification: 07/29/2015 | Effective: 08/28/2015 | Posted: 08/28/2015


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.
10.06.01i, Speech Therapy
Effective: 08/05/2015 | Posted: 08/05/2015
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

00.01.52c, Always Bundled Procedure Codes
Effective: 08/05/2015 | Posted: 08/05/2015
Type of policy change: Coverage and/or Reimbursement Position

08.01.08a, Coverage of Prescription Oral Anticancer Drugs and Biologics as Provided Under the Company's Medical Benefit
Effective: 08/10/2015 | Posted: 08/10/2015
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

05.00.50k, Ostomy Supplies
Notification: 07/15/2015 | Effective: 08/14/2015 | Posted: 08/14/2015
Type of policy change: Medical Coding

05.00.73c, Neuromuscular Electrical Stimulators (NMES) and Functional Electrical Stimulators (FES)
Notification: 07/15/2015 | Effective: 08/14/2015 | Posted: 08/14/2015
Type of policy change: Medical Coding

06.00.01e, Computer Analysis and Generation of Automated Data in Conjunction with Diagnostic Studies
Effective: 08/26/2015 | Posted: 08/26/2015
Type of policy change: General Description, Guidelines, or Informational Update

11.00.02f, Treatment of Medical and Surgical Complications
Effective: 08/26/2015 | Posted: 08/26/2015
Type of policy change: General Description, Guidelines, or Informational Update

07.07.02h, Ultraviolet Light Therapy for the Treatment of Dermatological Conditions
Effective: 08/26/2015 | Posted: 08/26/2015
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update


Reissue Policies
The following commercial policies have been reviewed, and no substantive changes were made.
05.00.01i, Pneumatic Compression Therapy Devices for Lymphedema and Chronic Venous Insufficiency
Reissue Effective: 08/19/2015 | Reissue Posted: 08/19/2015

07.07.03i, Photodynamic Therapy (PDT) Using Levulan® Kerastick® (Aminolevulinic Acid HCl [ALA]) or Metvixia® (Methyl Aminolevulinate [MAL])
Reissue Effective: 08/19/2015 | Reissue Posted: 08/19/2015

11.16.01g, Septoplasty, Rhinoplasty, and Septorhinoplasty
Reissue Effective: 08/19/2015 | Reissue Posted: 08/19/2015

07.13.01f, Orthoptic/Pleoptic Training
Reissue Effective: 08/19/2015 | Reissue Posted: 08/19/2015

08.01.00c, Hydroxyprogesterone Caproate Injection as a Technique to Reduce the Risk of Preterm Birth in High-Risk Pregnancies
Reissue Effective: 08/19/2015 | Reissue Posted: 08/19/2015

09.00.56a, Radiation Therapy Services (Independence Blue Cross)
Reissue Effective: 08/19/2015 | Reissue Posted: 08/19/2015

12.00.01e, Acupuncture
Reissue Effective: 08/19/2015 | Reissue Posted: 08/19/2015

07.03.05r, Sleep Disorder Testing and Positive Airway Pressure Therapy
Reissue Effective: 08/19/2015 | Reissue Posted: 08/19/2015

11.02.17e, Endovascular Stent-Graft Repair of Thoracic Aortic Aneurysms and Nonaneurysmal Lesions
Reissue Effective: 08/19/2015 | Reissue Posted: 08/19/2015

07.00.03m, Full-Body Monoplace or Multiplace Chamber Hyperbaric Oxygen Therapy
Reissue Effective: 08/19/2015 | Reissue Posted: 08/19/2015

11.14.23c, Surgical Treatment of Femoroacetabular Impingement
Reissue Effective: 08/20/2015 | Reissue Posted: 08/20/2015

05.00.05h, Equipment, Supplies, and Pharmaceuticals for the Treatment of Diabetes
Reissue Effective: 08/19/2015 | Reissue Posted: 08/20/2015

05.00.16d, Blood Pressure Devices for Home Use
Reissue Effective: 08/19/2015 | Reissue Posted: 08/20/2015

05.00.45h, Repair or Replacement of an External Prosthetic Device
Reissue Effective: 08/20/2015 | Reissue Posted: 08/20/2015

05.00.26c, Prothrombin Time Monitor for Home Anticoagulation Management
Reissue Effective: 08/19/2015 | Reissue Posted: 08/20/2015


Archived Policies
Independence Blue Cross has determined that it is no longer necessary for the following commercial policy to remain active.
03.00.10l, Modifiers LT/RT: Left Side/Right Side Procedures
Notification: 07/28/2015 | Archive Effective: 08/28/2015 | Posted: 08/28/2015


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