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News & AnnouncementsCoverage of the COVID-19 Vaccination for Independence Members (Updated March 1, 2021)3/1/2021
News & AnnouncementsPharmaceutical Treatments of COVID-19 for Independence Commercial Members (Updated March 12, 2021)3/12/2021
NotificationsWheelchair Options and Accessories05.00.67q3/12/2021 2:00 PM4/12/20213/12/2021Medical Necessity Criteria
NotificationsPower Wheelchairs (PWCs), Power-Operated Vehicles (POVs), and Push-Rim Activated Power-Assist Devices05.00.54h3/12/2021 2:00 PM3/29/20213/12/2021Medical Necessity Criteria
NotificationsLipectomy and Liposuction11.08.03k3/30/2021 2:00 PM6/28/20213/30/2021Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
New PoliciesMargetuximab-cmkb (Margenza)08.01.753/1/20213/1/2021This is a New Policy.
Updated PoliciesReconstructive Breast Surgery and Post-Mastectomy Prostheses 11.08.15z3/1/20213/1/2021Coverage and/or Reimbursement Position;Medical Coding
Updated PoliciesManual Wheelchairs05.00.12h1/29/2021 12:00 PM3/1/20213/1/2021Medical Necessity Criteria
Updated PoliciesBrentuximab Vedotin (Adcetris®)08.01.13e3/1/20213/1/2021Medical Necessity Criteria;Medical Coding
Updated PoliciesLanreotide (Somatuline® Depot)08.01.40c3/1/20213/1/2021Medical Necessity Criteria
Updated PoliciesTocilizumab (Actemra®) for Intravenous Infusion08.00.85k12/8/2020 1:00 PM3/8/20213/8/2021Coverage and/or Reimbursement Position;Medical Necessity Criteria
Updated PoliciesAbatacept (Orencia®) for Injection for Intravenous Use08.00.62l12/8/2020 1:00 PM3/8/20213/8/2021Coverage and/or Reimbursement Position;Medical Necessity Criteria
Updated PoliciesGonadotropin-Releasing Hormone Agonist (Eligard®, Fensolvi®, Lupron Depot®)08.01.33c12/8/2020 1:00 PM3/8/20213/8/2021Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update
Updated PoliciesMusculoskeletal Services (Independence)00.01.66d3/8/20213/8/2021General Description, Guidelines, or Informational Update
Updated PoliciesPercutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound (Independence)11.02.27d12/14/2020 2:00 PM3/14/20213/15/2021Medical Necessity Criteria;General Description, Guidelines, or Informational Update
Updated PoliciesHigh-Technology Radiology Services (Independence)09.00.46af12/14/2020 3:00 PM3/14/20213/15/2021General Description, Guidelines, or Informational Update
Updated PoliciesKnee Orthoses05.00.47o2/12/2021 2:00 PM3/15/20213/15/2021Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesBurosumab-twza (Crysvita®)08.01.49b3/15/20213/15/2021Medical Necessity Criteria
Updated PoliciesEndovascular Grafts for Abdominal Aortic Aneurysms (AAA), Aortic-Iliac Aneurysms, and Infrarenal Aortic Aneurysms11.02.10o12/30/20193/15/2021Coverage and/or Reimbursement Position
Updated PoliciesBelimumab (Benlysta®) for Intravenous Use08.00.99d3/15/20213/15/2021Medical Necessity Criteria
Updated PoliciesPegloticase (Krystexxa®)08.01.02f3/15/20213/15/2021Medical Necessity Criteria;General Description, Guidelines, or Informational Update
Updated PoliciesSubcutaneous Implantable Cardioverter Defibrillator (S-ICD) for Treating Life-threatening Ventricular Tachyarrhythmia05.00.77b12/22/2020 11:00 AM3/22/20213/22/2021Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesGender Affirming Interventions11.09.02j3/26/20213/25/2021General Description, Guidelines, or Informational Update
Updated PoliciesModifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS00.10.18n12/29/2020 12:00 AM3/29/20213/29/2021General Description, Guidelines, or Informational Update
Reissue PoliciesPercutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting of the Extracranial Carotid Artery or Intracranial Artery11.02.12i10/1/20183/12/20213/10/2021
Reissue PoliciesTildrakizumab-asmn (Ilumya™)08.01.48b2/24/20203/10/20213/10/2021
Reissue PoliciesFull-Body Computerized Tomography (CT) Scan Screening09.00.24c3/25/20153/10/20213/12/2021
Reissue PoliciesEvaluation and Management (E&M) of Diabetic Peripheral Neuropathy with Loss of Protective Sensation (LOPS)07.03.15d6/28/20173/10/20213/12/2021
Reissue PoliciesDebridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails11.08.17j10/1/20203/10/20213/12/2021
Reissue PoliciesFrenectomy, Frenotomy, or Frenoplasty for Ankyloglossia (Tongue-Tie)11.03.05e1/1/20213/24/20213/24/2021
Reissue PoliciesOff-label Coverage for Prescription Drugs and/or Biologics08.00.15f5/4/20203/24/20213/24/2021
Reissue PoliciesBrachytherapy and Accelerated Whole Breast Irradiation using Three-Dimensional Conformation Radiation Therapy09.00.10z7/15/20193/24/20213/24/2021
Reissue PoliciesHigh Osmolar Contrast Agents09.00.13c12/30/20153/24/20213/24/2021
Reissue PoliciesLow Osmolar Contrast Agents09.00.31d12/30/20153/24/20213/24/2021
Reissue PoliciesHome Prothrombin Time Monitoring05.00.26i11/4/20193/24/20213/24/2021
Reissue PoliciesNebulizers and Inhalation Solutions05.00.15r8/3/20203/24/20213/24/2021
Reissue PoliciesNoncontraceptive Use of the Levonorgestrel-Releasing Intrauterine System07.10.05m4/20/20203/24/20213/25/2021
Reissue PoliciesElective Abortion11.06.02i10/1/20183/24/20213/25/2021
Reissue PoliciesBilling Requirements for Multiple Births for Professional Providers00.10.38a12/30/20193/25/2021
Reissue PoliciesParenterally Administered Terbutaline Sulfate for the Prevention or Treatment of Pre-Term Labor07.10.04c2/22/20173/24/20213/26/2021
Reissue PoliciesFirst-Trimester Prenatal Screening for Fetal Aneuploidy Using Fetal Ultrasound Markers09.00.36l3/23/20203/10/20213/26/2021
Reissue PoliciesFetal Surgery11.00.03j5/7/20183/10/20213/26/2021
Reissue PoliciesTreatment of Twin-Twin Transfusion Syndrome (TTTS)11.00.14f8/12/20193/10/20213/26/2021