Medicare Advantage
  
  
  
  
  
  
  
  
  
  
  
  
News & AnnouncementsCoverage of COVID-19 Vaccination for Medicare Advantage Members (Updated September 8, 2021)9/8/2021Coverage of COVID-19 Vaccination for Medicare Advantage Members (Updated September 8, 2021)
News & AnnouncementsPharmaceutical Treatments of COVID-19 for Independence Medicare Advantage Members (Updated September 13, 2021)9/13/2021Pharmaceutical Treatments of COVID-19 for Independence Medicare Advantage Members (Updated September 13, 2021)
NotificationsPain Management of Peripheral Nerves by InjectionMA07.047h9/27/2021 12:00 PM12/27/20219/27/2021Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational UpdatePain Management of Peripheral Nerves by Injection
Updated PoliciesContinuous Glucose Monitors and Artificial Pancreas Device Systems (APDS)MA00.002h7/18/20219/10/2021Medical Necessity CriteriaContinuous Glucose Monitors and Artificial Pancreas Device Systems (APDS)
Updated PoliciesEvaluation and Treatment of Erectile Dysfunction (ED)MA11.079d6/8/2021 11:00 AM9/13/20219/13/2021Coverage and/or Reimbursement Position;General Description, Guidelines, or Informational UpdateEvaluation and Treatment of Erectile Dysfunction (ED)
Updated PoliciesModifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative PeriodMA03.008c9/13/20219/13/2021Coverage and/or Reimbursement Position;General Description, Guidelines, or Informational UpdateModifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period
Updated PoliciesModifier 79:  Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative PeriodMA03.012d9/13/20219/13/2021Coverage and/or Reimbursement Position;General Description, Guidelines, or Informational UpdateModifier 79:  Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
Updated PoliciesSteroid-Eluting Sinus Stents and ImplantsMA11.107f9/13/20219/13/2021Medical Necessity Criteria;General Description, Guidelines, or Informational UpdateSteroid-Eluting Sinus Stents and Implants
Updated PoliciesHigh-Technology Radiology ServicesMA09.002r6/14/2021 2:00 PM9/12/20219/13/2021General Description, Guidelines, or Informational UpdateHigh-Technology Radiology Services
Updated PoliciesAsparaginase erwinia chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze™)MA08.085d9/13/20219/13/2021Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational UpdateAsparaginase erwinia chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze™)
Updated PoliciesErythropoiesis Stimulating Agents (ESAs)MA08.011f9/27/20219/27/2021Medical Necessity CriteriaErythropoiesis Stimulating Agents (ESAs)
Updated PoliciesPemetrexed (Alimta®), Pemetrexed (Pemfexy™)MA08.047g9/27/20219/27/2021Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational UpdatePemetrexed (Alimta®), Pemetrexed (Pemfexy™)
Updated PoliciesAbatacept (Orencia®) for Injection for Intravenous UseMA08.028f9/27/20219/27/2021Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational UpdateAbatacept (Orencia®) for Injection for Intravenous Use
Reissue PoliciesHigh-Frequency Chest Wall Oscillation DevicesMA05.001e10/1/20209/8/20219/9/2021High-Frequency Chest Wall Oscillation Devices
Reissue PoliciesChemical PeelsMA11.103a12/16/20159/8/20219/9/2021Chemical Peels
Reissue PoliciesGolimumab (Simponi® Aria™) Intravenous (IV) InjectionMA08.070e12/21/20209/8/20219/9/2021Golimumab (Simponi® Aria™) Intravenous (IV) Injection
Reissue PoliciesCatheter Ablation of Cardiac ArrhythmiasMA11.060c10/1/20199/8/20219/10/2021Catheter Ablation of Cardiac Arrhythmias
Reissue PoliciesComputer-Aided Detection (CAD) System for Use with Chest RadiographsMA09.014a3/11/20159/8/20219/10/2021Computer-Aided Detection (CAD) System for Use with Chest Radiographs
Reissue PoliciesLabiaplastyMA11.067d5/14/20189/22/20219/22/2021Labiaplasty
Reissue PoliciesAmbulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) MonitoringMA07.026g7/1/20219/22/20219/24/2021Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring
Reissue PoliciesNonemergent Inpatient Video Electroencephalogram (EEG) Monitoring and Ambulatory EEG Monitoring in the HomeMA07.053a1/1/20209/22/20219/24/2021Nonemergent Inpatient Video Electroencephalogram (EEG) Monitoring and Ambulatory EEG Monitoring in the Home
Reissue PoliciesReconstructive Breast SurgeryMA11.030f1/1/20219/22/20219/24/2021Reconstructive Breast Surgery
Archived PoliciesProstate Mapping BiopsyMA11.016a9/10/2021 11:00 AM10/11/20219/10/2021Prostate Mapping Biopsy
Archived PoliciesExternal Counterpulsation (ECP)MA07.012a9/27/2021 6:00 PM10/25/20219/27/2021External Counterpulsation (ECP)