Medicare Advantage
  
  
  
  
  
  
  
  
  
  
  
NotificationsMedical and Surgical Treatment of Temporomandibular Joint DisorderMA07.024e9/1/2020 12:00 PM11/30/20209/1/2020Coverage and/or Reimbursement Position9/30/2020Medical and Surgical Treatment of Temporomandibular Joint Disorder
NotificationsSkilled Nursing Facility (SNF): Skilled and Subacute Levels of CareMA02.0049/1/2020 12:00 PM11/1/20209/1/2020This is a New Policy.10/1/2020Skilled Nursing Facility (SNF): Skilled and Subacute Levels of Care
NotificationsTrigger Point InjectionsMA11.017g9/1/2020 12:00 PM11/30/20209/1/2020Medical CodingTrigger Point Injections
NotificationsEculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™)MA08.044g9/1/2020 12:00 PM11/30/20209/1/2020Coverage and/or Reimbursement PositionEculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™)
NotificationsCoagulation FactorsMA08.004r9/29/2020 12:00 PM12/28/20209/29/2020Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational UpdateCoagulation Factors
New Policiescrizanlizumab-tmca (Adakveo®)MA08.1099/14/20209/14/2020This is a New Policy.crizanlizumab-tmca (Adakveo®)
New Policieslurbinectedin (Zepzelca)MA08.1259/14/20209/14/2020This is a New Policy.lurbinectedin (Zepzelca)
New PoliciesInebilizumab-cdon (Uplizna)MA08.1269/14/20209/14/2020This is a New Policy.Inebilizumab-cdon (Uplizna)
Updated PoliciesPercutaneous Coronary Intervention, Coronary Angiography and Arterial UltrasoundMA11.113c 11/10/20199/14/2020General Description, Guidelines, or Informational UpdatePercutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound
Updated PoliciesUrological SuppliesMA05.054e7/26/20209/14/2020Coverage and/or Reimbursement PositionUrological Supplies
Updated PoliciesPembrolizumab (Keytruda®)MA08.1219/14/20209/14/2020Coverage and/or Reimbursement PositionPembrolizumab (Keytruda®)
Updated PoliciesNivolumab (Opdivo®)MA08.1209/14/20209/14/2020Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational UpdateNivolumab (Opdivo®)
Updated PoliciesIpilimumab (Yervoy®)MA08.059g9/14/20209/14/2020Medical Necessity CriteriaIpilimumab (Yervoy®)
Updated PoliciesAvelumab (Bavencio®)MA08.1229/14/20209/14/2020Medical Necessity CriteriaAvelumab (Bavencio®)
Updated PoliciesDurvalumab (Imfinzi™)MA08.1239/14/20209/14/2020Medical Necessity CriteriaDurvalumab (Imfinzi™)
Updated PoliciesTreatments for Complex Regional Pain Syndrome (CRPS)MA08.026g9/28/20209/28/2020Medical Necessity Criteria;Medical CodingTreatments for Complex Regional Pain Syndrome (CRPS)
Updated PoliciesAtezolizumab (Tecentriq®)MA08.1279/28/20209/28/2020Medical Necessity CriteriaAtezolizumab (Tecentriq®)
Reissue PoliciesRoutine Foot Care for Certain Medical ConditionsMA07.009g10/1/20198/26/20209/3/2020Routine Foot Care for Certain Medical Conditions
Reissue PoliciesExternal Counterpulsation (ECP)MA07.012a9/30/20168/26/20209/3/2020External Counterpulsation (ECP)
Reissue PoliciesImplantable Steroid-Eluting Sinus StentsMA11.107d7/1/20208/26/20209/3/2020Implantable Steroid-Eluting Sinus Stents
Reissue PoliciesLaboratory-Based Vestibular Function TestingMA07.031a10/1/20199/11/20209/11/2020Laboratory-Based Vestibular Function Testing
Reissue PoliciesMentoplasty or GenioplastyMA11.080a6/30/20179/11/20209/11/2020Mentoplasty or Genioplasty
Reissue PoliciesLysis of Epidural AdhesionsMA11.095a2/24/20169/11/20209/11/2020Lysis of Epidural Adhesions
Reissue PoliciesMigraine Deactivation SurgeryMA11.0981/1/20159/11/20209/11/2020Migraine Deactivation Surgery
Reissue PoliciesNucleoplastyMA11.1011/1/20159/11/20209/11/2020Nucleoplasty
Reissue PoliciesEdaravone (Radicava™)MA08.092a1/1/20199/11/20209/11/2020Edaravone (Radicava™)
Reissue PoliciesTranscranial Magnetic Stimulation (TMS)MA07.035c9/10/20189/24/20209/24/2020Transcranial Magnetic Stimulation (TMS)
Reissue PoliciesPercutaneous Left Atrial Appendage (LAA) Closure for Non-Valvular Atrial Fibrillation (NVAF)MA11.013b10/1/20199/24/20209/24/2020Percutaneous Left Atrial Appendage (LAA) Closure for Non-Valvular Atrial Fibrillation (NVAF)
Reissue PoliciesMagnetoencephalography (MEG) with Magnetic Source Imaging (MSI)MA07.039e1/28/20159/24/20209/24/2020Magnetoencephalography (MEG) with Magnetic Source Imaging (MSI)
Reissue PoliciesElectron Beam Computed Tomography (EBCT) for Screening EvaluationsMA09.011a3/11/20159/23/20209/25/2020Electron Beam Computed Tomography (EBCT) for Screening Evaluations
Reissue PoliciesFull-Body Computerized Tomography (CT) Scan ScreeningMA09.012a3/25/20159/23/20209/25/2020Full-Body Computerized Tomography (CT) Scan Screening
Reissue PoliciesTranscatheter Closure of Cardiac Septal DefectsMA11.040b11/17/20179/23/20209/25/2020Transcatheter Closure of Cardiac Septal Defects