| News & Announcements | 10/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products | | | | | | 10/1/2024 | | | |
| News & Announcements | 10/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Commercial Products (Updated October 8, 2024) | | | | | | 10/10/2024 | | | |
| New Policies | Lifileucel (Amtagvi™) | 08.02.22 | | 10/21/2024 | | | 10/21/2024 | This is a New Policy. | | |
| Updated Policies | Sacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for the Control of Incontinence | 11.17.04y | | 10/1/2024 | | | 10/1/2024 | Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Tocilizumab (Actemra®) and Related Biosimilars for Intravenous Infusion | 08.00.85p | | 10/1/2024 | | | 10/7/2024 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®) | 08.00.50ad | | 10/7/2024 | | | 10/7/2024 | Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Assays of Genetic Expression in Tumor Tissue for Breast Cancer Prognosis (Independence Administrators) | 06.02.27o | | 10/7/2024 | | | 10/7/2024 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Efgartigimod alfa - fcab (Vyvgart) and efgartigimod alfa and hyaluronidase-qvfc (Vyvgart Hytrulo) | 08.01.84d | | 10/7/2024 | | | 10/7/2024 | Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Sacituzumab govitecan-hziy (Trodelvy™) | 08.01.60f | | 10/7/2024 | | | 10/7/2024 | Medical Necessity Criteria | | |
| Updated Policies | Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG) | 08.00.13aj | 7/16/2024 10:00 AM | 10/14/2024 | | | 10/14/2024 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Maintenance Treatment of Opioid or Alcohol Use Disorder | 08.01.37d | | 10/2/2024 | | | 10/21/2024 | Medical Necessity Criteria | | |
| Updated Policies | Risankizumab-rzaa (Skyrizi®) for Intravenous Use | 08.01.95c | | 10/21/2024 | | | 10/21/2024 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Trilaciclib (Cosela™) | 08.01.77e | | 10/21/2024 | | | 10/21/2024 | Medical Necessity Criteria | | |
| Updated Policies | Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound (Independence) | 11.02.27i | | 10/20/2024 | | | 10/21/2024 | Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | High-Technology Radiology Services (Independence) | 09.00.46ar | | 10/20/2024 | | | 10/21/2024 | General Description, Guidelines, or Informational Update | | |
| Updated Policies | Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies | 07.03.05aa | | 10/20/2024 | | | 10/21/2024 | Coverage and/or Reimbursement Position;Medical Necessity Criteria | | |
| Updated Policies | Musculoskeletal Services (Independence) | 00.01.66m | | 10/20/2024 | | | 10/21/2024 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis or Recurrent Acute Rhinosinusitis | 11.16.06k | | 10/21/2024 | | | 10/21/2024 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Emapalumab-lzsg (Gamifant®) | 08.01.54c | | 10/21/2024 | | | 10/21/2024 | Coverage and/or Reimbursement Position | | |
| Updated Policies | patisiran (Onpattro®) and vutrisiran (Amvuttra®) | 08.01.50d | | 10/21/2024 | | | 10/21/2024 | Medical Necessity Criteria | | |
| Updated Policies | Nadofaragene Firadenovec-vncg (Adstiladrin®) | 08.02.11b | | 10/21/2024 | | | 10/21/2024 | Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Microprocessor-Controlled Prostheses for Lower-Extremity Amputees | 11.14.21k | 9/27/2024 5:00 PM | 10/28/2024 | | | 10/28/2024 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Proton Beam Radiation Therapy (Independence Administrators) | 09.00.49n | 7/30/2024 3:00 PM | 10/28/2024 | | | 10/28/2024 | Medical Necessity Criteria | | |
| Reissue Policies | Procedures for the Treatment of Gastroesophageal Reflux Disease (GERD) | 11.03.11q | | 1/2/2023 | 10/2/2024 | | 10/2/2024 | | | |
| Reissue Policies | Interleukin-5 (IL-5) Antagonist (e.g., Cinqair®) | 08.01.23i | | 10/4/2021 | 10/2/2024 | | 10/2/2024 | | | |
| Reissue Policies | Loncastuximab tesirine-lpyl (Zynlonta®) | 08.00.59c | | 10/23/2023 | 10/2/2024 | | 10/2/2024 | | | |
| Reissue Policies | Chemical Peels | 11.08.08h | | 12/26/2022 | 10/2/2024 | | 10/2/2024 | | | |
| Reissue Policies | Procedures for the Treatment of Acne | 11.08.29e | | 10/1/2016 | 10/2/2024 | | 10/2/2024 | | | |
| Reissue Policies | Selective Photothermolysis Using Pulsed-Dye Lasers (PDL) | 11.08.04i | | 7/11/2022 | 10/2/2024 | | 10/2/2024 | | | |
| Reissue Policies | Catheter Ablation of Cardiac Arrhythmias | 11.02.06q | | 10/1/2023 | 10/16/2024 | | 10/16/2024 | | | |
| Reissue Policies | STAT Laboratory Tests Performed in the Outpatient Hospital Setting for Health Maintenance Organization (HMO) and Point of Service (POS) Products | 00.01.41c | | 1/1/2021 | 10/16/2024 | | 10/16/2024 | | | |
| Reissue Policies | Diagnostic Radiology Services Included in Capitation | 00.03.02ae | | 1/1/2024 | 10/16/2024 | | 10/16/2024 | | | |
| Reissue Policies | Physical Medicine and Rehabilitation Services Eligible for Reimbursement Above Capitation to Physical and Occupational Therapy (PT/OT) Providers for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Serv | 00.03.06f | | 10/1/2019 | 10/16/2024 | | 10/16/2024 | | | |
| Reissue Policies | Day Rehabilitation | 10.00.02c | | 1/13/2020 | 10/16/2024 | | 10/16/2024 | | | |
| Reissue Policies | Tumor Treating Fields | 07.03.26a | | 1/27/2020 | 10/16/2024 | | 10/16/2024 | | | |
| Reissue Policies | Intra-Articular Injection of Hyaluronan for the Treatment of Osteoarthritis | 11.14.07x | | 4/1/2021 | 10/16/2024 | | 10/16/2024 | | | |
| Reissue Policies | Esophagogastroduodenoscopy (EGD) and Endoscopic Retrograde Cholangiopancreatography (ERCP) | 07.02.22h | | 1/2/2024 | 10/16/2024 | | 10/16/2024 | | | |
| Reissue Policies | Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies | 07.05.07e | | 10/1/2024 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) | 07.13.06n | | 10/1/2024 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Coverage of Medical Devices | 05.00.04e | | 11/4/2019 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum | 05.00.48k | | 1/18/2021 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Insertion of Implantable Infusion Pumps | 11.15.03o | | 10/1/2024 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Pulmonary Rehabilitation | 10.04.01m | | 1/1/2022 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Scar Revision | 11.08.25n | | 12/19/2022 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Polatuzumab vedotin-piiq (Polivy®) | 08.01.59e | | 1/1/2024 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | In Vitro Allergy Testing | 06.02.26e | | 12/19/2022 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Nebulizers and Inhalation Solutions | 05.00.15t | | 1/1/2024 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Lurbinectedin (Zepzelca®) | 08.01.67c | | 5/8/2023 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Sutimlimab-jome (Enjaymo) | 08.01.87a | | 10/1/2022 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Treatment of Pulmonary Artery Hypertension with Intravenous, Subcutaneous, and Inhaled Pharmacologic Agents | 08.00.25n | | 1/1/2024 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Coverage of Anticancer Prescription Oral and Injectable Drugs and Biologics and Supportive Agents | 08.01.08r | | 10/1/2024 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | In Vivo Allergy Sensitivity Testing | 07.00.05i | | 12/5/2022 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Ultraviolet Light Therapy for the Treatment of Dermatological Conditions | 07.07.02o | | 10/1/2024 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Pain Management of Peripheral Nerves by Injection | 07.03.27 | | 12/27/2021 | 10/30/2024 | | 10/30/2024 | | | |
| Reissue Policies | Power Wheelchairs (PWCs), Power-Operated Vehicles (POVs), and Push-Rim Activated Power-Assist Devices | 05.00.54k | | 11/20/2023 | 10/30/2024 | | 10/30/2024 | | | |
| Coding Update | Ultraviolet Light Therapy for the Treatment of Dermatological Conditions | 07.07.02o | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Treatment of Medical and Surgical Complications | 11.00.02i | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Vagus Nerve Stimulation (VNS) | 11.15.16v | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Brentuximab Vedotin (Adcetris®) | 08.01.13j | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Prescription Digital Therapeutics and Mobile-Based Health Management Applications | 12.00.05c | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices | 07.02.09j | | 10/1/2024 | 10/1/2024 | | 10/1/2024 | | | |
| Coding Update | Knee Orthoses | 05.00.47t | | 10/1/2024 | 10/1/2024 | | 10/1/2024 | | | |
| Coding Update | Transcutaneous Electrical Nerve Stimulators (TENS) and Associated Supplies | 05.00.74j | | 10/1/2024 | 10/1/2024 | | 10/1/2024 | | | |
| Coding Update | Carfilzomib (Kyprolis®) | 08.01.05k | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Equipment, Supplies, and Pharmaceuticals for the Treatment of Diabetes | 05.00.05s | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Esophagogastroduodenoscopy (EGD) and Endoscopic Retrograde Cholangiopancreatography (ERCP) | 07.02.22h | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Home-Based Sleep Studies | 07.03.01d | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Denervation of the Spinal Nerves for Chronic Pain (Independence Administrators) | 11.15.09q | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Anesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint Management | 01.00.12c | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Transcatheter Cardiac Valve Procedures | 11.02.25j | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Wireless Capsule Endoscopy for Gastrointestinal (GI) Disorders | 07.05.02s | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Nivolumab (Opdivo®) | 08.01.62d | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Epcoritamab-bysp (EPKINLY™) | 08.02.12a | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty | 11.16.01l | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies | 07.05.07e | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Panniculectomy, Abdominoplasty, Abdominal Lipectomy, and Other Excisions of Redundant Skin | 11.08.06k | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Radioembolization for Primary and Metastatic Tumors of the Liver | 09.00.48h | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Radioimmunotherapy with Ibritumomab Tiuxetan (Zevalin®) (Independence Administrators) | 08.00.08k | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Removal of Breast Implants | 11.08.14o | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Speech and Non-Speech Generating Devices | 05.00.32m | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Transcatheter Arterial Chemoembolization (TACE) of Hepatic Malignancies | 07.05.06h | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Octreotide Acetate (Sandostatin® LAR Depot) | 08.01.10j | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Autonomic Nervous System Testing | 07.03.23g | | 10/1/2024 | 10/1/2024 | | 10/1/2024 | | | |
| Coding Update | Preventive Care Services | 00.06.02as | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Pemetrexed (Pemfexy™) | 08.00.87n | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Teplizumab-mzwv (Tzield) | 08.01.99a | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Treatments for Complex Regional Pain Syndrome (CRPS) | 08.00.57s | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Self-Administered Drugs and Biologics | 08.00.78as | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Omalizumab (Xolair®) | 08.00.55k | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Coverage of Anticancer Prescription Oral and Injectable Drugs and Biologics and Supportive Agents | 08.01.08r | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG) | 08.00.13ai | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Tafasitamab-cxix (Monjuvi®) | 08.01.81d | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Asparaginase Erwinia Chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze®) | 08.01.35h | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Chimeric Antigen Receptor (CAR) Therapy | 08.01.43n | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Denosumab (Prolia®, Xgeva®), Romosozumab-aqqg (Evenity®) | 08.00.94s | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Glofitamab-gxbm (Columvi) | 08.02.07c | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use | 08.00.66v | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Lanreotide (Somatuline® Depot) | 08.01.40g | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound)/(Abraxane® for Injectable Suspension) | 08.00.90r | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Pembrolizumab (Keytruda®) | 08.01.63e | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) | 07.13.06n | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Insertion of Implantable Infusion Pumps | 11.15.03o | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Photodynamic Therapy (PDT) Using Verteporfin (Visudyne®) | 07.13.05l | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds | 11.08.20am | | 10/1/2024 | | | 10/1/2024 | | | |
| Coding Update | Modifier 62: Two Surgeons | 00.10.11aa | | 10/1/2024 | | | 10/4/2024 | | | |
| Coding Update | Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS | 00.10.18y | | 10/1/2024 | | | 10/4/2024 | | | |
| Coding Update | Modifier 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 Service | 03.00.06aa | | 10/1/2024 | | | 10/4/2024 | | | |
| Coding Update | Magnetic Resonance Imaging (MRI) Contrast Agents | 09.00.45l | | 10/1/2024 | | | 10/9/2024 | | | |
| Coding Update | Repair and Replacement of Durable Medical Equipment (DME) and Prosthetic Devices | 05.00.44r | | 10/1/2024 | | | 10/10/2024 | | | |
| Coding Update | Durable Medical Equipment (DME) and Consumable Medical Supplies | 05.00.21ae | | 10/1/2024 | | | 10/10/2024 | | | |
| Coding Update | Always Bundled Procedure Codes | 00.01.52w | | 10/1/2024 | | | 10/15/2024 | | | |
| Coding Update | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | 00.01.25bp | | 10/1/2024 | | | 10/16/2024 | | | |
| Coding Update | Reimbursement for Radiopharmaceutical Agents for Professional Providers | 09.00.32af | | 10/1/2024 | | | 10/28/2024 | | | |
| Archived Policies | Transcatheter Closure of Cardiac Septal Defects | 11.02.11h | 10/18/2024 11:00 AM | 11/18/2024 | | | 10/18/2024 | | | |
