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.
08.01.28c, Sebelipase alfa (Kanuma®)
Notification: 09/04/2018 | Effective: 12/03/2018 | Posted: 09/04/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; 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.
00.01.60b, Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services
Effective: 01/01/2017 | Posted: 09/07/2018
Type of policy change: Coverage and/or Reimbursement Position

11.01.01j, Otoplasty or Non-Surgical External Ear Molding
Notification: 06/12/2018 | Effective: 09/10/2018 | Posted: 09/10/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

11.01.02n, Cochlear Implant
Effective: 09/10/2018 | Posted: 09/10/2018
Type of policy change: Medical Necessity Criteria

07.13.06k, Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Notification: 06/13/2018 | Effective: 09/10/2018 | Posted: 09/10/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

07.03.22c, Transcranial Magnetic Stimulation (TMS)
Effective: 09/10/2018 | Posted: 09/10/2018
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

08.01.44b, Voretigene Neparvovec-rzyl (Luxturna™)
Effective: 09/24/2018 | Posted: 09/24/2018
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

09.00.32t, Reimbursement for Diagnostic and Therapeutic Radiopharmaceutical Agents for Professional Providers
Effective: 09/24/2018 | Posted: 09/24/2018
Type of policy change: General Description, Guidelines, or Informational Update


Reissue Policies
The following commercial policies have been reviewed, and no substantive changes were made.
06.02.29d, AlloMap™ Molecular Expression Testing for Heart Transplant Rejection (Independence Administrators)
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

06.02.56, Noninvasive Techniques for the Evaluation and Monitoring of Individuals with Chronic Liver Disease
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

06.02.04d, Fetal Fibronectin Enzyme (fFN) Immunoassay
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

06.02.14h, In Vitro Chemosensitivity and Chemoresistance Assays
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

07.05.06f, Transcatheter Arterial Chemoembolization (TACE) of Hepatic Malignancies
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

11.00.13f, Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

07.05.07c, Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

09.00.48f, Radioembolization for Primary and Metastatic Tumors of the Liver (Independence Administrators)
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

08.01.03c, Belatacept (Nulojix®)
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

08.01.08c, Coverage of Prescription Oral Anticancer Drugs and/or Biologics as Provided Under the Company's Medical Benefit
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

08.00.15d, Off-label Coverage for Prescription Drugs and/or Biologics
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

11.08.29e, Procedures for the Treatment of Acne
Reissue Effective: 09/12/2018 | Reissue Posted: 09/12/2018

11.08.06i, Panniculectomy, Abdominoplasty, and Other Excisions of Redundant Skin
Reissue Effective: 09/26/2018 | Reissue Posted: 09/26/2018

08.00.91c, Alpha 1-Antitrypsin Therapy (e.g., Prolastin-C®, Aralast NP™, Glassia™, Zemaira™)
Reissue Effective: 09/26/2018 | Reissue Posted: 09/26/2018

10.06.01k, Speech Therapy
Reissue Effective: 09/26/2018 | Reissue Posted: 09/26/2018

05.00.55i, Wheelchair Cushions and Seating
Reissue Effective: 09/26/2018 | Reissue Posted: 09/26/2018

07.03.24, Laboratory-Based Vestibular Function Testing
Reissue Effective: 09/26/2018 | Reissue Posted: 09/26/2018

08.00.84d, Eculizumab (Soliris®)
Reissue Effective: 09/26/2018 | Reissue Posted: 09/26/2018

11.16.01h, Septoplasty, Rhinoplasty, and Septorhinoplasty
Reissue Effective: 09/26/2018 | Reissue Posted: 09/26/2018

00.01.48c, Marijuana for Medical Use
Reissue Effective: 09/26/2018 | Reissue Posted: 09/26/2018

05.00.12g, Manual Wheelchairs
Reissue Effective: 09/26/2018 | Reissue Posted: 09/26/2018


Archived Policies
Independence Blue Cross has determined that it is no longer necessary for the following commercial policy to remain active.
09.00.53, Magnetic Resonance Imaging (MRI) for Monitoring the Integrity of Silicone-Gel-Filled Breast Implants in Asymptomatic Individuals
Notification: 09/28/2018 | Archive Effective: 10/29/2018 | Posted: 09/28/2018


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