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NotificationsReporting Requirements for Drugs and Biologics00.01.49f10/20/2023 10:00 AM11/20/202311/13/2023General Description, Guidelines, or Informational Update11/13/2023
NotificationsReporting Requirements for Drugs and Biologics00.01.49f10/20/2023 10:00 AM11/20/202311/14/2023General Description, Guidelines, or Informational Update
New PoliciesTofersen (Qalsody™)08.02.0610/1/202311/6/2023This is a New Policy.
Updated PoliciesInsulin Pumps and Long-Term Interstitial Continuous Glucose Monitoring Systems05.00.79i11/1/202311/1/2023Medical Necessity Criteria;General Description, Guidelines, or Informational Update
Updated PoliciesShort-term Interstitial Continuous Glucose Monitoring Systems (CGMS)05.00.24s11/1/202311/1/2023Medical Necessity Criteria
Updated PoliciesMusculoskeletal Services (Independence)00.01.66j11/5/202311/6/2023Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding
Updated PoliciesLyme Disease: Diagnosis and Intravenous (IV) Antibiotic Therapy06.02.01k11/6/202311/6/2023Medical Necessity Criteria;General Description, Guidelines, or Informational Update
Updated PoliciesExperimental/Investigational Services12.01.01bj10/1/202311/6/2023Medical Coding
Updated PoliciesIntensity-Modulated Radiation Therapy (IMRT) (Independence Administrators)09.00.17q11/6/202311/6/2023Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update
Updated PoliciesEnfortumab vedotin-ejfv (Padcev®)08.00.43e11/6/202311/6/2023Medical Necessity Criteria
Updated PoliciesTocilizumab (Actemra®) for Intravenous Infusion08.00.85n8/16/2023 10:00 AM11/13/202311/13/2023Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesDirect Access to Obstetrics/Gynecology (OB/GYN) Services00.09.01k11/13/202311/13/2023Medical Coding
Updated PoliciesFull-Body Monoplace or Multiplace Chamber Hyperbaric Oxygen Therapy07.00.03p11/15/202311/15/2023Medical Necessity Criteria
Updated PoliciesTreatment of Obstructive Sleep Apnea (OSA) and Primary Snoring11.00.06r11/15/202311/15/2023Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesCardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs10.01.01q11/15/202311/15/2023Medical Coding
Updated PoliciesAmbulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring07.02.21n11/15/202311/15/2023Medical Coding
Updated PoliciesReporting Requirements for Drugs and Biologics00.01.49f10/20/2023 10:00 AM11/20/202311/20/2023General Description, Guidelines, or Informational Update
Updated PoliciesPower Wheelchairs (PWCs), Power-Operated Vehicles (POVs), and Push-Rim Activated Power-Assist Devices05.00.54j11/20/202311/20/2023General Description, Guidelines, or Informational Update
Updated PoliciesWheelchair Options and Accessories05.00.67s10/21/2023 11:00 AM11/20/202311/21/2023Coverage and/or Reimbursement Position;Medical Coding
Updated PoliciesDaratumumab (Darzalex®), Daratumumab and Hyaluronidase-fihj (Darzalex Faspro®)08.01.29k8/29/2023 2:00 PM11/27/202311/27/2023Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update
Reissue PoliciesTranscranial Magnetic Stimulation (TMS)07.03.22e1/1/202311/1/202311/1/2023
Reissue PoliciesReimbursement for Associated Services Performed in Conjunction with Dental Care00.01.18g10/1/202311/1/202311/1/2023
Reissue PoliciesModifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS00.10.18u7/1/202311/1/202311/1/2023
Reissue PoliciesRoutine Costs Associated with Qualifying Clinical Trials07.00.20g7/5/202111/1/202311/1/2023
Reissue PoliciesReporting and Documentation Requirements for Anesthesia Services00.01.14s1/1/202211/1/202311/1/2023
Reissue PoliciesBilling for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus00.10.39p1/1/202311/1/202311/1/2023
Reissue PoliciesHematopoietic Stem Cell Transplantation (Bone Marrow Transplant)11.07.01x10/1/202211/1/202311/1/2023
Reissue PoliciesTumor Treating Fields07.03.26a1/27/202011/1/202311/1/2023
Reissue PoliciesSelective Photothermolysis Using Pulsed-Dye Lasers (PDL)11.08.04i7/11/202211/1/202311/1/2023
Reissue PoliciesIntravenous Chelation Therapy07.00.02j10/1/202311/1/202311/1/2023
Reissue PoliciesPediatric Intensive Day Feeding Program10.00.031/28/201911/1/202311/1/2023
Reissue PoliciesDrug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies07.05.07d12/16/201911/1/202311/1/2023
Reissue PoliciesSurgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)11.17.06q7/1/202211/1/202311/1/2023
Reissue PoliciesCryosurgical Ablation of the Prostate Gland11.11.03d4/6/201511/1/202311/1/2023
Reissue PoliciesProcedures for the Treatment of Acne11.08.29e10/1/201611/1/202311/1/2023
Reissue PoliciesScanning Computerized Ophthalmic Diagnostic Imaging (SCODI)07.13.06m10/11/202111/1/202311/1/2023
Reissue PoliciesApheresis Therapy06.03.04n1/1/201811/1/202311/1/2023
Reissue PoliciesChemical Peels11.08.08h12/26/202211/1/202311/1/2023
Reissue PoliciesExon Skipping Drugs for Duchenne Muscular Dystrophy (DMD) (Eteplirsen (Exondys 51), Golodirsen (Vyondys 53), Viltolarsen (Viltepso)), Casimersen (Amondys 45)08.01.34c10/1/202111/1/202311/1/2023
Reissue PoliciesScar Revision11.08.25n12/19/202211/1/202311/1/2023
Reissue PoliciesUpper Limb Prostheses05.00.72f4/15/201911/1/202311/1/2023
Reissue PoliciesTranscatheter Arterial Chemoembolization (TACE) of Hepatic Malignancies07.05.06g12/2/201911/1/202311/1/2023
Reissue PoliciesRadioembolization for Primary and Metastatic Tumors of the Liver09.00.48g12/2/201911/1/202311/1/2023
Reissue PoliciesBreast Pumps05.00.76g1/1/202311/1/202311/1/2023
Reissue PoliciesStem-Cell Therapy/Platelet-Rich Plasma for Orthopedic Applications and ​Platelet-Rich Plasma/Platelet-Derived Growth Factor for Wound Healing and Other Miscellaneous Non-Orthopedic Conditions07.07.09i7/11/202211/1/202311/1/2023
Reissue PoliciesMultigene Expression Assays for Predicting Recurrence in Colon Cancer (Independence Administrators)06.02.32d7/1/201611/1/202311/1/2023
Reissue PoliciesBetibeglogene Autotemcel [Beti-Cel (ZYNTEGLO®)]08.01.891/1/202311/1/202311/1/2023
Reissue PoliciesRapid Whole Exome Sequencing (rWES) and Rapid Whole Genome Sequencing (rWGS) for Diagnosis of Genetic Disorders06.02.461/1/202311/1/202311/1/2023
Reissue PoliciesReconstructive Breast Surgery and Post-Mastectomy Prostheses 11.08.15aa10/1/202211/1/202311/1/2023
Reissue PoliciesLutathera® (Lutetium Lu 177 Dotatate) (Independence Administrators)08.01.576/29/201911/1/202311/1/2023
Coding UpdateMonoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's Disease08.01.93b7/6/202311/6/2023
Coding UpdateeviCore Lab Management (Independence)06.02.52ad10/1/202311/13/2023
Archived PoliciesEdaravone (Radicava®)08.01.42a11/15/2023 9:00 AM1/2/202411/15/2023
Archived PoliciesBortezomib (Bortezomib for Injection, Velcade®)08.00.73p11/15/2023 9:00 AM1/2/202411/15/2023
Archived PoliciesAprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®)08.01.41e11/30/2023 5:00 PM1/2/202411/30/2023