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News & AnnouncementsCoverage of the COVID-19 Vaccination for Independence Commercial Members (Updated May 2, 2022)5/2/2022
NotificationsTelemedicine Services00.10.41j3/1/2022 9:00 AM6/1/20225/11/2022Medical Necessity Criteria5/11/20223/1/2022
New PoliciesGIVOSIRAN (GIVLAARI®)08.00.214/1/2022 1:00 PM5/2/20225/2/2022This is a New Policy.
New PoliciesIntravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®)08.01.801/4/2022 2:00 PM4/4/20225/2/2022This is a New Policy.5/2/2022
New PoliciesAllogeneic Processed Thymus Tissue-agdc (Rethymic®)08.01.884/13/2022 3:00 PM5/16/20225/16/2022This is a New Policy.
Updated PoliciesBotulinum Toxin Agents08.00.26y5/9/20225/9/2022Medical Necessity Criteria;Medical Coding
Updated PoliciesUstekinumab (Stelara®)08.00.82m5/9/20225/9/2022Medical Necessity Criteria;Medical Coding
Updated PoliciesDenosumab (Prolia®, Xgeva®), Romosozumab-aqqg (Evenity®)08.00.94p5/9/20225/9/2022Medical Necessity Criteria
Reissue PoliciesSmell and Taste Dysfunction Testing07.11.01c5/7/20185/4/20225/4/2022
Reissue PoliciesPain Management of Peripheral Nerves by Injection07.03.2712/27/20215/4/20225/4/2022
Reissue PoliciesEnzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase®, Vimizim®, Naglazyme®, Mepsevii™, etc.)08.00.70e6/3/20195/4/20225/4/2022
Reissue PoliciesReimbursement for Components of Comprehensive Laboratory Panels00.01.61a6/15/20205/4/20225/4/2022
Reissue PoliciesInterleukin-5 (IL-5) Antagonist (e.g., Cinqair®)08.01.23i10/4/20215/4/20225/5/2022
Reissue PoliciesLaboratory-Based Vestibular Function Testing07.03.24b1/1/20215/4/20225/5/2022
Reissue PoliciesElectromyography (EMG) (Needle and Non-Needle) of the Anal or Urethral Sphincter07.03.21l10/1/20195/4/20225/5/2022
Reissue PoliciesTreatment of Pulmonary Artery Hypertension with Intravenous, Subcutaneous, and Inhaled Pharmacologic Agents08.00.25m11/22/20215/4/20225/6/2022
Reissue PoliciesMohs' Micrographic Surgery11.08.23j10/1/20185/4/20225/9/2022
Reissue PoliciesApplication and Removal of Tattoos11.08.05g7/20/20125/4/20225/9/2022
Reissue PoliciesOctreotide Acetate (Sandostatin® LAR Depot)08.01.10g10/25/20215/4/20225/9/2022
Reissue PoliciesInebilizumab-cdon (Uplizna)08.01.68b8/9/20215/4/20225/9/2022
Reissue PoliciesBurosumab-twza (Crysvita®)08.01.49b3/15/20215/4/20225/9/2022
Reissue PoliciesAlglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® )08.00.72k4/1/20225/4/20225/9/2022
Reissue PoliciesCerliponase alfa (Brineura®)08.01.39c6/3/20195/4/20225/9/2022
Reissue PoliciesEnzyme Replacement for the Treatment of Gaucher's Disease08.00.51k6/7/20215/4/20225/9/2022
Reissue PoliciesRepair of Cleft Lip, Cleft Nose, and/or Cleft Palate11.03.01f12/21/20205/18/20225/18/2022
Reissue PoliciesSurgical Correction of Strabismus11.05.07d9/7/20165/18/20225/18/2022
Reissue PoliciesBelantamab mafodotin-blmf (Blenrep)08.01.70b4/1/20215/18/20225/18/2022
Reissue PoliciesGastric Electrical Stimulation (Enterra™), Gastric Pacing11.03.15i11/30/20205/18/20225/18/2022
Reissue PoliciesRefractive Keratoplasty11.05.01f7/1/20195/18/20225/18/2022
Reissue PoliciesImplantation of Intrastromal Corneal Ring Segments (ICRS)11.05.11c9/7/20165/18/20225/18/2022
Reissue PoliciesRemoval of Breast Implants11.08.14m10/1/20215/18/20225/18/2022
Reissue PoliciesContact Lenses for the Treatment of Persistent (Corneal) Epithelial Defects07.13.11k10/1/20215/18/20225/18/2022
Reissue PoliciesIslet Cell Transplantation11.04.01d1/1/20205/18/20225/18/2022
Reissue PoliciesLabiaplasty11.06.09d5/14/20185/18/20225/18/2022
Reissue PoliciesLysis of Epidural Adhesions11.15.13d2/14/20165/18/20225/18/2022
Reissue PoliciesPartial Coherence Interferometry07.13.08e4/23/20185/18/20225/18/2022
Reissue PoliciesMentoplasty or Genioplasty11.14.01g6/25/20175/18/20225/18/2022
Reissue PoliciesSurgical Treatments of Athletic Pubalgia11.14.26a6/3/20155/18/20225/18/2022
Coding UpdateModifier 50: Bilateral Procedure03.00.05s4/1/20225/9/2022