| News & Announcements | 01/01/2022 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products (Updated January 7, 2022) | | | | | | 1/7/2022 | | | 01/01/2022 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products (Updated January 7, 2022) | |
| News & Announcements | Pharmaceutical Prophylaxis and Treatments of COVID-19 for Independence Medicare Advantage Members (Updated January 11, 2022) | | | | | | 1/11/2022 | | | Pharmaceutical Prophylaxis and Treatments of COVID-19 for Independence Medicare Advantage Members (Updated January 11, 2022) | |
| News & Announcements | Coverage of the COVID-19 Vaccination for Medicare Advantage Members (Updated January 28, 2022) | | | | | | 1/28/2022 | | | Coverage of the COVID-19 Vaccination for Medicare Advantage Members (Updated January 28, 2022) | |
| Notifications | Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®) | MA08.137 | 1/4/2022 3:00 PM | 4/4/2022 | | | 1/4/2022 | This is a New Policy. | | Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®) | |
| Updated Policies | Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults | MA05.047g | 12/3/2021 5:00 AM | 1/3/2022 | 1/3/2022 | | 1/3/2022 | Medical Necessity Criteria;General Description, Guidelines, or Informational Update | 1/3/2022 | Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults | |
| Updated Policies | Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products | MA00.030v | | 1/1/2022 | | | 1/3/2022 | Coverage and/or Reimbursement Position | | Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products | |
| Updated Policies | Preventive Care Services | MA00.003r | | 1/1/2022 | | | 1/3/2022 | Medical Necessity Criteria | | Preventive Care Services | |
| Updated Policies | Avelumab (Bavencio®) | MA08.122a | | 1/3/2022 | | | 1/3/2022 | Medical Necessity Criteria | | Avelumab (Bavencio®) | |
| Updated Policies | Durvalumab (Imfinzi®) | MA08.123a | | 1/3/2022 | | | 1/3/2022 | Medical Necessity Criteria | | Durvalumab (Imfinzi®) | |
| Updated Policies | Cemiplimab-rwlc (Libtayo®) | MA08.124a | | 1/3/2022 | | | 1/3/2022 | Medical Necessity Criteria | | Cemiplimab-rwlc (Libtayo®) | |
| Updated Policies | 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 | MA03.003j | | 1/1/2022 | | | 1/4/2022 | General Description, Guidelines, or Informational 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 | |
| Updated Policies | Experimental/Investigational Services | MA00.005ab | 10/12/2021 7:00 AM | 1/10/2022 | | | 1/10/2022 | Medical Coding | 1/10/2022 | Experimental/Investigational Services | |
| Updated Policies | Hyperbaric Oxygen Therapy | MA07.001b | | 1/31/2022 | | | 1/31/2022 | Medical Necessity Criteria | | Hyperbaric Oxygen Therapy | |
| Updated Policies | Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG) | MA08.009o | | 1/31/2022 | | | 1/31/2022 | Medical Necessity Criteria;Medical Coding | | Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG) | |
| Updated Policies | Modifiers XE, XS, XP, XU, and 59 | MA03.005c | | 1/31/2022 | | | 1/31/2022 | General Description, Guidelines, or Informational Update | | Modifiers XE, XS, XP, XU, and 59 | |
| Coding Update | Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ) | MA08.036e | | 1/1/2022 | | | 1/4/2022 | | | Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ) | |
| Coding Update | Asparaginase erwinia chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze™) | MA08.085e | | 1/1/2022 | | | 1/4/2022 | | | Asparaginase erwinia chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze™) | |
| Coding Update | Dostarlimab-gxly (Jemperli) | MA08.136b | | 1/1/2022 | | | 1/4/2022 | | | Dostarlimab-gxly (Jemperli) | |
| Coding Update | Ostomy Supplies | MA05.014c | | 1/1/2022 | | | 1/4/2022 | | | Ostomy Supplies | |
| Coding Update | Anifrolumab-fnia (Saphnelo™) | MA08.140a | | 1/1/2022 | | | 1/4/2022 | | | Anifrolumab-fnia (Saphnelo™) | |
| Coding Update | Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds | MA11.015o | | 1/1/2022 | | | 1/4/2022 | | 1/4/2022 | Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds | |
| Coding Update | Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus | MA00.037k | | 1/1/2022 | | | 1/5/2022 | | | Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus | |
| Coding Update | Always Bundled Procedure Codes | MA00.026m | | 1/1/2022 | | | 1/10/2022 | | | Always Bundled Procedure Codes | |
| Coding Update | Care Management and Care Planning Services | MA00.006i | | 1/1/2022 | | | 1/11/2022 | | | Care Management and Care Planning Services | |
| Coding Update | Gender Affirming Interventions | MA11.106g | | 1/1/2022 | | | 1/12/2022 | | | Gender Affirming Interventions | |
| Coding Update | Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids | MA11.049d | | 1/1/2022 | | | 1/12/2022 | | | Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids | |
| Coding Update | Hematopoietic Stem Cell Transplantation | MA11.002i | | 1/1/2022 | | | 1/12/2022 | | | Hematopoietic Stem Cell Transplantation | |
| Coding Update | Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers | MA00.033j | | 1/1/2022 | | | 1/14/2022 | | | Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers | |
| Coding Update | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | MA00.010ag | | 1/1/2022 | | | 1/14/2022 | | | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | |
| Coding Update | Direct Access to Obstetrics/Gynecology (OB/GYN) Services | MA00.032d | | 1/1/2022 | | | 1/18/2022 | | | Direct Access to Obstetrics/Gynecology (OB/GYN) Services | |
| Coding Update | Reimbursement for Radiopharmaceutical Agents for Professional Providers | MA09.009o | | 1/1/2022 | | | 1/19/2022 | | | Reimbursement for Radiopharmaceutical Agents for Professional Providers | |
| Coding Update | Radiologic Guidance and/or Supervision and Interpretation of a Procedure | MA00.019i | | 1/1/2022 | | | 1/25/2022 | | | Radiologic Guidance and/or Supervision and Interpretation of a Procedure | |
| Coding Update | Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products | MA00.030w | | 1/1/2022 | | | 1/31/2022 | | | Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products | |