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News & Announcements1/01/2022 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products (Updated January 7, 2022)1/7/2022
News & AnnouncementsPharmaceutical Prophylaxis and Treatments of COVID-19 for ​Independence Commercial Members (Updated January 11, 2022)1/11/2022
NotificationsIntravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®)08.01.801/4/2022 2:00 PM4/4/20221/4/2022This is a New Policy.
NotificationsInfliximab and Related Biosimilars08.00.34q1/14/2022 10:00 AM2/15/20221/14/2022Coverage and/or Reimbursement Position;General Description, Guidelines, or Informational Update
Updated PoliciesTreatment of Obstructive Sleep Apnea (OSA) and Primary Snoring11.00.06m12/3/2021 6:00 AM1/3/20221/3/20221/3/2022Medical Necessity Criteria;General Description, Guidelines, or Informational Update1/3/2022
Updated PoliciesLaboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products00.03.07ae1/1/20221/3/2022Coverage and/or Reimbursement Position
Updated PoliciesRoutine/Non-routine Vaccines08.01.04z12/1/2021 12:00 PM1/1/20221/3/2022Medical Necessity Criteria;Medical Coding1/3/2022
Updated PoliciesAvelumab (Bavencio®)08.01.64a1/3/20221/3/2022Medical Necessity Criteria
Updated PoliciesDurvalumab (Imfinzi®)08.01.65a1/3/20221/3/2022Medical Necessity Criteria
Updated PoliciesCemiplimab-rwlc (Libtayo®)08.01.66a1/3/20221/3/2022Medical Necessity Criteria
Updated PoliciesModifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service03.00.06v1/1/20221/4/2022Coverage and/or Reimbursement Position;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesExperimental/Investigational Services12.01.01bc10/12/2021 2:00 PM1/10/20221/10/2022Medical Coding1/10/2022
Updated PoliciesBreast Pumps05.00.76e12/17/2021 10:00 AM1/17/20221/17/2022Medical Necessity Criteria
Coding UpdateCoverage of Anticancer Prescription Oral and Injectable Drugs and Biologics and Supportive Agents08.01.08g1/1/20221/4/2022
Coding UpdateAlglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® )08.00.72j1/1/20221/4/2022
Coding UpdateAsparaginase Erwinia Chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze™)08.01.35e1/1/20221/4/2022
Coding UpdateDostarlimab-gxly (Jemperli)08.01.79b1/1/20221/4/2022
Coding UpdateEvaluation and Management of Autism Spectrum Disorder (ASD)07.03.07x1/1/20221/4/2022
Coding UpdateOstomy Supplies05.00.50m1/1/20221/4/2022
Coding UpdateSacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for the Control of Incontinence11.17.04u1/1/20221/4/2022
Coding UpdateAnifrolumab-fnia (Saphnelo™)08.01.82a1/1/20221/4/2022
Coding UpdateWound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds11.08.20aa1/1/20221/4/20221/4/2022
Coding UpdateBilling for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus00.10.39o1/1/20221/5/2022
Coding UpdateAlways Bundled Procedure Codes00.01.52o1/1/20221/10/2022
Coding UpdateCare Management and Care Planning Services00.01.59i1/1/20221/11/2022
Coding UpdateBone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids11.01.06f1/1/20221/12/2022
Coding UpdateGender Affirming Interventions11.09.02k1/1/20221/12/2022
Coding UpdateHematopoietic Stem Cell Transplantation (Bone Marrow Transplant)11.07.01u1/1/20221/12/2022
Coding UpdateServices Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers00.10.01ae1/1/20221/14/2022
Coding UpdateDirect Access to Obstetrics/Gynecology (OB/GYN) Services00.09.01i1/1/20221/18/2022
Coding UpdateReimbursement for Radiopharmaceutical Agents for Professional Providers09.00.32z1/1/20221/19/2022
Coding UpdateDiagnostic Radiology Services Included in Capitation00.03.02ac1/1/20221/19/2022