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News & Announcements4/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products4/1/2021
NotificationsSpinal Discectomy (Independence Administrators)11.14.29h4/1/2021 7:00 AM7/1/20214/1/2021Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
NotificationsTelemedicine Services (Independence)00.10.41h4/1/2021 5:00 PM7/1/20214/1/2021Medical Necessity Criteria
NotificationsContrast Agents Used in Conjunction with Echocardiography09.00.11e4/2/2021 2:00 PM5/3/20214/2/2021General Description, Guidelines, or Informational Update
NotificationsRoutine Costs Associated with Qualifying Clinical Trials07.00.20g4/6/2021 2:00 PM7/5/20214/6/2021General Description, Guidelines, or Informational Update
NotificationsExperimental/Investigational Services12.01.01ba4/12/2021 12:00 PM7/12/20214/12/2021Coverage and/or Reimbursement Position;Medical Coding
New PoliciesFilgrastim  (Neupogen ®) and related biosimilars, and tbo-filgrastim (Granix ®)08.01.7312/31/2020 10:00 AM4/1/20214/1/2021This is a New Policy.
Updated PoliciesCoverage of Anticancer Prescription Oral and Injectable Drugs and Biologics and Supportive Agents08.01.08e4/1/20214/1/2021Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update
Updated PoliciesPPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services00.01.25bb4/1/20214/1/2021Coverage and/or Reimbursement Position
Updated Policiespegfilgrastim (Neulasta®) and related biosimilars08.01.32e12/31/2020 2:00 PM4/1/20214/1/2021Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesCochlear Implant11.01.02p4/12/20214/12/2021Medical Necessity Criteria
Updated PoliciesIntensity-Modulated Radiation Therapy (IMRT) (Independence Administrators)09.00.17p4/12/20214/12/2021Coverage and/or Reimbursement Position;Medical Necessity Criteria
Updated PoliciesIntravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists and Related Biosimilars08.00.74o4/12/20214/12/2021Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesWheelchair Options and Accessories05.00.67q3/12/2021 2:00 PM4/12/20214/12/2021Medical Necessity Criteria
Updated PoliciesPower Wheelchairs (PWCs), Power-Operated Vehicles (POVs), and Push-Rim Activated Power-Assist Devices05.00.54h3/12/2021 2:00 PM4/12/20214/12/2021Medical Necessity Criteria
Updated PoliciesMagnetic Resonance Imaging (MRI) Contrast Agents09.00.45i4/12/20214/12/2021General Description, Guidelines, or Informational Update
Reissue PoliciesSpeech Therapy10.06.01l1/1/20204/7/20214/7/2021
Reissue PoliciesNoninvasive Prenatal Screening for Fetal Aneuploidies Using Cell-Free Fetal DNA (Independence Administrators)06.02.47d4/1/20203/24/20214/8/2021
Reissue PoliciesGenetic Testing for Congenital Long QT Syndrome (Independence Administrators)06.02.31g1/1/20213/24/20214/9/2021
Reissue PoliciesGPS Cancer™ Testing by NantHealth06.02.503/1/20163/24/20214/9/2021
Reissue PoliciesFetal Fibronectin Enzyme (fFN) Immunoassay06.02.04d12/4/20153/24/20214/9/2021
Reissue PoliciesGenetic Testing for Inherited Susceptibility to Colon Cancer and Microsatellite Instability Testing (Familial Adenomatous Polyposis and Lynch Syndrome) (Independence Administrators)06.02.10r1/1/20213/24/20214/9/2021
Reissue PoliciesVeriStrat® Testing for Targeted Therapy in Non-Small Cell Lung Cancer06.02.49b5/6/20163/24/20214/9/2021
Reissue PoliciesVectra® DA Blood Test for Rheumatoid Arthritis06.02.452/1/20163/24/20214/9/2021
Reissue PoliciesHuman Immunodeficiency Virus (HIV) Genotyping and Phenotyping (Independence Administrators)06.02.09g7/1/20163/24/20214/9/2021
Reissue PoliciesImmune Cell Function Assay06.02.37a11/6/20153/24/20214/9/2021
Reissue PoliciesRepository Corticotropin (H.P. Acthar® Gel Injection)08.01.12b7/1/20154/7/20214/9/2021
Coding UpdateVagus Nerve Stimulation (VNS)11.15.16p4/1/20214/1/2021
Coding UpdateIntra-Articular Injection of Hyaluronan for the Treatment of Osteoarthritis11.14.07x4/1/20214/1/2021
Coding UpdateImmune Globulin Intravenous (IVIG), Subcutaneous (SCIG)08.00.13ab4/1/20214/1/2021
Coding UpdateMicroprocessor-Controlled Prostheses for Lower-Extremity Amputees11.14.21i4/1/20214/1/2021
Coding UpdateAnkle-Foot/Knee-Ankle-Foot Orthoses05.00.39q4/1/20214/1/2021
Coding UpdateImplantable Steroid-Eluting Sinus Stents11.16.08e4/1/20214/1/2021
Coding UpdateChimeric Antigen Receptor (CAR) Therapy08.01.43g4/1/20214/1/2021
Coding UpdateExon Skipping Drugs for Duchenne Muscular Dystrophy (DMD) (Eteplirsen (Exondys 51), Golodirsen (Vyondys 53), Viltolarsen (Viltepso))08.01.34a4/1/20214/1/2021
Coding UpdateGenetic Testing (Independence Administrators)06.02.35ab4/1/20214/2/2021
Coding UpdateeviCore Lab Management (Independence)06.02.52t4/1/20214/2/2021
Coding UpdateModifier 50: Bilateral Procedure03.00.05p4/1/20214/5/2021
Coding UpdateBelantamab mafodotin-blmf (Blenrep)08.01.70b4/1/20214/5/2021
Coding UpdateAlways Bundled Procedure Codes00.01.52l4/1/20214/5/2021
Coding UpdateModifier 62: Two Surgeons00.10.11p4/1/20214/5/2021
Coding UpdateReimbursement for Radiopharmaceutical Agents for Professional Providers09.00.32w4/1/20214/5/2021
Coding UpdateModifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS00.10.18o4/1/20214/8/2021
Coding UpdateRepair and Replacement of Durable Medical Equipment (DME) and Prosthetic Devices05.00.44n4/1/20214/8/2021
Coding UpdateDurable Medical Equipment (DME) and Consumable Medical Supplies05.00.21x4/1/20214/8/2021