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News & AnnouncementsWaiver of certain requirements during COVID-19 outbreak related to Durable Medical Equipment (DME), prosthetics, orthotics, and supplies for Medicare Advantage members (Updated December 15, 2021)8/2/2022Waiver of certain requirements during COVID-19 outbreak related to Durable Medical Equipment (DME), prosthetics, orthotics, and supplies for Medicare Advantage members (Updated December 15, 2021)
News & AnnouncementsLaboratory Testing, Vaccination, and Treatment for Monkeypox for Medicare Advantage Members8/24/2022Laboratory Testing, Vaccination, and Treatment for Monkeypox for Medicare Advantage Members
News & AnnouncementsPharmaceutical Prophylaxis and Treatments of COVID-19 for Independence Medicare Advantage Members (Updated August 25, 2022)8/25/2022Pharmaceutical Prophylaxis and Treatments of COVID-19 for Independence Medicare Advantage Members (Updated August 25, 2022)
NotificationsNebulizers and Inhalation SolutionsMA05.007e8/5/2022 9:00 AM9/5/20228/5/2022Medical Necessity CriteriaNebulizers and Inhalation Solutions
NotificationsDurable Medical Equipment (DME)MA05.044l8/5/2022 2:00 PM9/5/20228/5/2022Coverage and/or Reimbursement Position;Medical CodingDurable Medical Equipment (DME)
NotificationsHospital Beds and AccessoriesMA05.002e8/12/2022 9:00 AM9/12/20228/12/2022Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational UpdateHospital Beds and Accessories
NotificationsAprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®)MA08.091d8/30/2022 10:00 AM11/28/20228/30/2022Medical Necessity CriteriaAprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®)
Updated PoliciesRadiologic Guidance and/or Supervision and Interpretation of a ProcedureMA00.019j8/1/20228/1/2022Medical CodingRadiologic Guidance and/or Supervision and Interpretation of a Procedure
Updated PoliciesHome Prothrombin Time MonitoringMA05.016g7/15/2022 9:00 AM8/15/20228/15/2022Medical Coding;General Description, Guidelines, or Informational UpdateHome Prothrombin Time Monitoring
Updated PoliciesWheelchair Cushions and SeatingMA05.023b7/15/2022 9:00 AM8/15/20228/15/2022General Description, Guidelines, or Informational UpdateWheelchair Cushions and Seating
Updated PoliciesSacituzumab govitecan-hziy (TrodelvyTM)MA08.118d8/15/20228/15/2022Medical Necessity CriteriaSacituzumab govitecan-hziy (TrodelvyTM)
Updated PoliciesDaratumumab (Darzalex®), Daratumumab, and Hyaluronidase-fihj (Darzalex Faspro®)MA08.079j8/15/20228/15/2022Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational UpdateDaratumumab (Darzalex®), Daratumumab, and Hyaluronidase-fihj (Darzalex Faspro®)
Updated PoliciesAsparaginase erwinia chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze™)MA08.085f8/15/20228/15/2022Medical Necessity Criteria;General Description, Guidelines, or Informational UpdateAsparaginase erwinia chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze™)
Updated PoliciesRadiofrequency, Cryosurgical and Microwave Ablation of Lung TumorsMA11.052c8/15/20228/15/2022Medical Necessity Criteria;General Description, Guidelines, or Informational UpdateRadiofrequency, Cryosurgical and Microwave Ablation of Lung Tumors
Updated PoliciesLipectomy and LiposuctionMA11.070c8/15/20228/15/2022Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational UpdateLipectomy and Liposuction
Updated PoliciesPaclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound)/(Abraxane® for Injectable Suspension)MA08.049j8/29/20228/29/2022Medical Necessity CriteriaPaclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound)/(Abraxane® for Injectable Suspension)
Updated PoliciesOutpatient Physical Medicine and Rehabilitation Services- Physical Therapy (PT) and Occupational Therapy (OT)MA10.003i8/29/20228/29/2022Coverage and/or Reimbursement Position;Medical CodingOutpatient Physical Medicine and Rehabilitation Services- Physical Therapy (PT) and Occupational Therapy (OT)
Updated PoliciesScreening for Vertebral Fracture with Dual-Energy X-ray Absorptiometry (DEXA/DXA)MA09.013b8/29/20228/29/2022Medical CodingScreening for Vertebral Fracture with Dual-Energy X-ray Absorptiometry (DEXA/DXA)
Updated PoliciesHome Health Care ServicesMA02.003c8/29/20228/29/2022Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational UpdateHome Health Care Services
Updated PoliciesMagnetic Resonance Imaging (MRI)--Guided Focused Ultrasound AblationMA09.021e8/29/20228/29/2022Medical Necessity Criteria;General Description, Guidelines, or Informational UpdateMagnetic Resonance Imaging (MRI)--Guided Focused Ultrasound Ablation
Updated PoliciesPercutaneous Image-Guided Lumbar Decompression (PILD) for Spinal StenosisMA11.097e8/29/20228/29/2022Coverage and/or Reimbursement PositionPercutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis
Reissue PoliciesTrigger Point InjectionsMA11.017h10/1/20217/27/20228/1/2022Trigger Point Injections
Reissue PoliciesMoxetumomab pasudotox-tdfk (Lumoxiti™)MA08.103b10/1/20198/10/20228/15/2022Moxetumomab pasudotox-tdfk (Lumoxiti™)
Reissue PoliciesSteroid-Eluting Sinus Stents and ImplantsMA11.107f9/13/20218/24/20228/24/2022Steroid-Eluting Sinus Stents and Implants
Reissue PoliciesElectron Beam Computed Tomography (EBCT) for Screening EvaluationsMA09.011b8/2/20218/24/20228/25/2022Electron Beam Computed Tomography (EBCT) for Screening Evaluations
Reissue PoliciesNonemergent Inpatient Video Electroencephalogram (EEG) Monitoring and Ambulatory EEG Monitoring in the HomeMA07.053a1/1/20208/24/20228/25/2022Nonemergent Inpatient Video Electroencephalogram (EEG) Monitoring and Ambulatory EEG Monitoring in the Home
Reissue PoliciesEndovascular Stent-Graft Repair of Thoracic Aortic Aneurysms and Nonaneurysmal LesionsMA11.062a1/1/20228/24/20228/25/2022Endovascular Stent-Graft Repair of Thoracic Aortic Aneurysms and Nonaneurysmal Lesions
Reissue PoliciesAcupunctureMA12.004c10/1/20218/24/20228/25/2022Acupuncture
Reissue PoliciesErythropoiesis Stimulating Agents (ESAs)MA08.011f9/27/20218/24/20228/26/2022Erythropoiesis Stimulating Agents (ESAs)