| News & Announcements | Consumer Grade Pulse Oximetry Devices For Use In The Home Setting (Updated October 01, 2021) | | | | | | 10/1/2021 | | | Consumer Grade Pulse Oximetry Devices For Use In The Home Setting (Updated October 01, 2021) | |
| News & Announcements | 10/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | | | | | | 10/1/2021 | | | 10/1/2021 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | |
| News & Announcements | Coverage of COVID-19 Vaccination for Medicare Advantage Members (updated October 15, 2021) | | | | | | 10/15/2021 | | | Coverage of COVID-19 Vaccination for Medicare Advantage Members (updated October 15, 2021) | |
| New Policies | Loncastuximab tesirine-lpyl (Zynlonta™) | MA08.139 | | 10/1/2021 | | | 10/1/2021 | This is a New Policy. | | Loncastuximab tesirine-lpyl (Zynlonta™) | |
| New Policies | Anifrolumab-fnia (Saphnelo™) | MA08.140 | | 10/11/2021 | | | 10/11/2021 | This is a New Policy. | | Anifrolumab-fnia (Saphnelo™) | |
| New Policies | Tafasitamab-cxix (Monjuvi®) | MA08.138 | | 10/11/2021 | | | 10/11/2021 | This is a New Policy. | | Tafasitamab-cxix (Monjuvi®) | |
| Updated Policies | Radiation Therapy Services | MA09.020m | 8/31/2021 10:00 AM | 10/1/2021 | | | 10/1/2021 | Medical Necessity Criteria | | Radiation Therapy Services | |
| Updated Policies | Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®) | MA08.022m | | 10/1/2021 | | | 10/1/2021 | Medical Necessity Criteria;Medical Coding | | Rituximab (Rituxan®) Infusion and Related Biosimilars, and Rituximab/Hyaluronidase Human for Subcutaneous Injection (Rituxan Hycela®) | |
| Updated Policies | Interleukin-5 (IL-5) Antagonist (e.g., Cinqair®, Nucala®) and IL-5 Receptor Antagonist (e.g., Fasenra®) | MA08.024i | 7/6/2021 1:00 PM | 10/4/2021 | | | 10/4/2021 | Coverage and/or Reimbursement Position;Medical Necessity Criteria | | Interleukin-5 (IL-5) Antagonist (e.g., Cinqair®, Nucala®) and IL-5 Receptor Antagonist (e.g., Fasenra®) | |
| Updated Policies | FROM: Alglucosidase alfa (e.g., Lumizyme®) TO: Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ) | MA08.036d | | 10/11/2021 | | | 10/11/2021 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | FROM: Alglucosidase alfa (e.g., Lumizyme®) TO: Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ) | |
| Updated Policies | Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) | MA07.004g | | 10/11/2021 | | | 10/11/2021 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding | | Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) | |
| Updated Policies | Experimental/Investigational Services | MA00.005aa | | 10/1/2021 | | | 10/11/2021 | Medical Coding | | Experimental/Investigational Services | |
| Updated Policies | Always Bundled Procedure Codes | MA00.026l | | 10/11/2021 | | | 10/11/2021 | Medical Coding | | Always Bundled Procedure Codes | |
| Updated Policies | Coagulation Factors | MA08.004s | | 10/25/2021 | | | 10/25/2021 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Coagulation Factors | |
| Updated Policies | Gonadotropin-Releasing Hormone Agonist (Eligard®, Fensolvi®, Lupron Depot®) | MA08.083f | | 10/25/2021 | | | 10/25/2021 | Medical Necessity Criteria | | Gonadotropin-Releasing Hormone Agonist (Eligard®, Fensolvi®, Lupron Depot®) | |
| Updated Policies | Octreotide Acetate (Sandostatin® LAR Depot) | MA08.065g | | 10/25/2021 | | | 10/25/2021 | Medical Necessity Criteria | | Octreotide Acetate (Sandostatin® LAR Depot) | |
| Updated Policies | Modifiers for Shared or Split Surgical Services (Modifiers 54, 55, 56) | MA03.017c | | 10/25/2021 | | | 10/25/2021 | Coverage and/or Reimbursement Position;General Description, Guidelines, or Informational Update | | Modifiers for Shared or Split Surgical Services (Modifiers 54, 55, 56) | |
| Reissue Policies | Coverage of Medical Devices | MA05.040b | | 11/4/2019 | 10/6/2021 | | 10/6/2021 | | | Coverage of Medical Devices | |
| Reissue Policies | Biofeedback Therapy | MA07.010a | | 10/6/2017 | 10/6/2021 | | 10/6/2021 | | | Biofeedback Therapy | |
| Reissue Policies | Artificial Intervertebral Lumbar Disc Insertion | MA11.114 | | 1/10/2021 | 10/6/2021 | | 10/6/2021 | | | Artificial Intervertebral Lumbar Disc Insertion | |
| Reissue Policies | Osteogenic Stimulators (Electrical and Ultrasonic) | MA05.018b | | 1/10/2021 | 10/6/2021 | | 10/6/2021 | | | Osteogenic Stimulators (Electrical and Ultrasonic) | |
| Reissue Policies | Wheelchair Cushions and Seating | MA05.023a | | 12/29/2017 | 10/6/2021 | | 10/7/2021 | | | Wheelchair Cushions and Seating | |
| Reissue Policies | Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs | MA10.002b | | 10/1/2017 | 10/6/2021 | | 10/7/2021 | | | Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs | |
| Reissue Policies | Lumbar Interspinous Process Decompression System | MA11.048c | | 5/21/2018 | 10/20/2021 | | 10/20/2021 | | | Lumbar Interspinous Process Decompression System | |
| Reissue Policies | Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies | MA07.041b | | 12/16/2019 | 10/20/2021 | | 10/21/2021 | | | Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies | |
| Reissue Policies | Photodynamic Therapy (PDT) Using Porfimer Sodium (Photofrin®) | MA07.030b | | 12/17/2018 | 10/20/2021 | | 10/21/2021 | | | Photodynamic Therapy (PDT) Using Porfimer Sodium (Photofrin®) | |
| Coding Update | Trigger Point Injections | MA11.017h | | 10/1/2021 | | | 10/1/2021 | | | Trigger Point Injections | |
| Coding Update | Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use | MA08.072h | | 10/1/2021 | | | 10/1/2021 | | | Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use | |
| Coding Update | Gonadotropin-Releasing Hormone Agonist (Eligard®, Fensolvi®, Lupron Depot®) | MA08.083e | | 10/1/2021 | | | 10/1/2021 | | | Gonadotropin-Releasing Hormone Agonist (Eligard®, Fensolvi®, Lupron Depot®) | |
| Coding Update | Chiropractic Services | MA10.004h | | 10/1/2021 | | | 10/1/2021 | | | Chiropractic Services | |
| Coding Update | Routine Foot Care for Certain Medical Conditions | MA07.009i | | 10/1/2021 | | | 10/1/2021 | | | Routine Foot Care for Certain Medical Conditions | |
| Coding Update | Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound)/(Abraxane® for Injectable Suspension) | MA08.049h | | 10/1/2021 | | | 10/1/2021 | | | Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound)/(Abraxane® for Injectable Suspension) | |
| Coding Update | Brentuximab Vedotin (Adcetris®) | MA08.068f | | 10/1/2021 | | | 10/1/2021 | | | Brentuximab Vedotin (Adcetris®) | |
| Coding Update | Pembrolizumab (Keytruda®) | MA08.121b | | 10/1/2021 | | | 10/1/2021 | | | Pembrolizumab (Keytruda®) | |
| Coding Update | Trilaciclib (Cosela™) | MA08.134b | | 10/1/2021 | | | 10/1/2021 | | | Trilaciclib (Cosela™) | |
| Coding Update | Transcutaneous Electrical Nerve Stimulators (TENS) and Associated Supplies | MA05.006g | | 10/1/2021 | | | 10/1/2021 | | | Transcutaneous Electrical Nerve Stimulators (TENS) and Associated Supplies | |
| Coding Update | Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS | MA00.015j | | 10/1/2021 | | | 10/1/2021 | | | Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS | |
| Coding Update | Modifier 62: Two Surgeons | MA00.011k | | 10/1/2021 | | | 10/1/2021 | | | Modifier 62: Two Surgeons | |
| Coding Update | Hyperthermic Intraperitoneal Chemotherapy for Select IntraAbdominal and Pelvic Malignancies | MA07.017d | | 10/1/2021 | | | 10/1/2021 | | | Hyperthermic Intraperitoneal Chemotherapy for Select IntraAbdominal and Pelvic Malignancies | |
| Coding Update | High-Frequency Chest Wall Oscillation Devices | MA05.001f | | 10/1/2021 | | | 10/1/2021 | | | High-Frequency Chest Wall Oscillation Devices | |
| Coding Update | Electromyography (EMG) Studies: Needle EMG, Surface EMG (SEMG) | MA07.050h | | 10/1/2021 | | | 10/1/2021 | | | Electromyography (EMG) Studies: Needle EMG, Surface EMG (SEMG) | |
| Coding Update | Nerve Conduction Studies (NCS) and Related Electrodiagnostic Studies | MA07.033h | | 10/1/2021 | | | 10/1/2021 | | | Nerve Conduction Studies (NCS) and Related Electrodiagnostic Studies | |
| Coding Update | Neuropsychological Testing for Neurologically Based Conditions | MA07.038g | | 10/1/2021 | | | 10/1/2021 | | | Neuropsychological Testing for Neurologically Based Conditions | |
| Coding Update | Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails | MA11.014g | | 10/1/2021 | | | 10/1/2021 | | | Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails | |
| Coding Update | Ultraviolet Light Therapy for the Treatment of Dermatological Conditions | MA07.002d | | 10/1/2021 | | | 10/1/2021 | | | Ultraviolet Light Therapy for the Treatment of Dermatological Conditions | |
| Coding Update | Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds | MA11.015m | | 10/1/2021 | | | 10/1/2021 | | | Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds | |
| Coding Update | evinacumab-dgnb (Evkeeza) | MA08.133b | | 10/1/2021 | | | 10/1/2021 | | | evinacumab-dgnb (Evkeeza) | |
| Coding Update | Acupuncture | MA12.004c | | 10/1/2021 | | | 10/1/2021 | | | Acupuncture | |
| Coding Update | Pulmonary Function Tests | MA07.007k | | 10/1/2021 | | | 10/1/2021 | | | Pulmonary Function Tests | |
| Coding Update | Lower Limb Prostheses | MA05.024d | | 10/1/2021 | | | 10/1/2021 | | | Lower Limb Prostheses | |
| Coding Update | Removal of Breast Implants | MA11.076f | | 10/1/2021 | | | 10/1/2021 | | | Removal of Breast Implants | |
| Coding Update | Dostarlimab-gxly (Jemperli) | MA08.136a | | 10/1/2021 | | | 10/1/2021 | | | Dostarlimab-gxly (Jemperli) | |
| Coding Update | Melphalan flufenamide (Pepaxto®) | MA08.135b | | 10/1/2021 | | | 10/1/2021 | | | Melphalan flufenamide (Pepaxto®) | |
| Coding Update | Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults | MA05.047f | | 10/1/2021 | | | 10/1/2021 | | | Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults | |
| Coding Update | Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services | MA01.005f | | 10/1/2021 | | | 10/1/2021 | | | Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services | |
| Coding Update | Modifier 50: Bilateral Procedure | MA03.002k | | 10/1/2021 | | | 10/1/2021 | | | Modifier 50: Bilateral Procedure | |
| Coding Update | Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic) | MA07.023g | | 10/1/2021 | | | 10/1/2021 | | | Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic) | |
| Coding Update | Chimeric Antigen Receptor (CAR) Therapy | MA08.093i | | 10/1/2021 | | | 10/1/2021 | | | Chimeric Antigen Receptor (CAR) Therapy | |
| Coding Update | Exon Skipping Drugs for Duchenne Muscular Dystrophy (DMD) (Eteplirsen (Exondys 51), Golodirsen (Vyondys 53), Viltolarsen (Viltepso)), Casimersen (Amondys 45) | MA08.084c | | 10/1/2021 | | | 10/1/2021 | | | Exon Skipping Drugs for Duchenne Muscular Dystrophy (DMD) (Eteplirsen (Exondys 51), Golodirsen (Vyondys 53), Viltolarsen (Viltepso)), Casimersen (Amondys 45) | |
| Coding Update | Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments | MA06.025o | | 10/1/2021 | | | 10/1/2021 | | | Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments | |
| Coding Update | eviCore Lab Management | MA06.034c | | 10/1/2021 | | | 10/4/2021 | | | eviCore Lab Management | |
| Coding Update | Durable Medical Equipment (DME) | MA05.044k | | 10/1/2021 | | | 10/6/2021 | | | Durable Medical Equipment (DME) | |
| Coding Update | Repair and Replacement of Durable Medical Equipment (DME) and Prosthetic Devices | MA05.062h | | 10/1/2021 | | | 10/6/2021 | | | Repair and Replacement of Durable Medical Equipment (DME) and Prosthetic Devices | |
| Coding Update | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | MA00.010af | | 10/1/2021 | | | 10/25/2021 | | | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | |
| Coding Update | Enteral Nutritional Therapy | MA08.003e | | 10/1/2021 | | | 10/25/2021 | | | Enteral Nutritional Therapy | |
| Archived Policies | Bronchial Thermoplasty | MA11.006b | 11/29/2020 2:00 PM | 1/3/2022 | | | 10/7/2021 | | | Bronchial Thermoplasty | |
| Archived Policies | Photography, including Documentation and Record-Keeping Photography, Whole Body Integumentary Photography, Dermoscopy, and Dermatoscopy | MA07.020a | 10/8/2021 10:00 AM | 11/8/2021 | | | 10/8/2021 | | | Photography, including Documentation and Record-Keeping Photography, Whole Body Integumentary Photography, Dermoscopy, and Dermatoscopy | |
