| Notifications | Care Management and Care Planning Services | MA00.006l | 10/7/2022 10:00 AM | 11/7/2022 | | | 10/7/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Care Management and Care Planning Services | |
| Notifications | Pemetrexed (Alimta®), Pemetrexed (Pemfexy™) | MA08.047h | 10/7/2022 9:00 AM | 11/7/2022 | | | 10/7/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Pemetrexed (Alimta®), Pemetrexed (Pemfexy™) | |
| New Policies | Risankizumab-rzaa (Skyrizi®) for Intravenous Use | MA08.153 | | 10/24/2022 | | | 10/24/2022 | This is a New Policy. | | Risankizumab-rzaa (Skyrizi®) for Intravenous Use | |
| Updated Policies | Medicare Part B vs. Part D Crossover Drugs | MA08.007ac | | 9/19/2022 | | | 10/7/2022 | Coverage and/or Reimbursement Position;Medical Coding | | Medicare Part B vs. Part D Crossover Drugs | |
| Updated Policies | Ipilimumab (Yervoy®) | MA08.059i | | 10/10/2022 | | | 10/10/2022 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Ipilimumab (Yervoy®) | |
| Updated Policies | Nivolumab (Opdivo®) | MA08.120b | | 10/10/2022 | | | 10/10/2022 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Nivolumab (Opdivo®) | |
| Updated Policies | Medical and Surgical Treatment of Temporomandibular Joint Disorder | MA07.024f | 9/9/2022 10:00 AM | 10/10/2022 | | | 10/10/2022 | Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Medical and Surgical Treatment of Temporomandibular Joint Disorder | |
| Updated Policies | Negative Pressure Wound Therapy (NPWT) Systems | MA05.008c | | 10/10/2022 | | | 10/10/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Negative Pressure Wound Therapy (NPWT) Systems | |
| Updated Policies | Eculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™) | MA08.044h | 9/19/2022 1:00 PM | 10/17/2022 | | | 10/17/2022 | Medical Necessity Criteria | | Eculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™) | |
| Updated Policies | Radiation Therapy Services | MA09.020o | | 10/15/2022 | | | 10/17/2022 | Medical Necessity Criteria | | Radiation Therapy Services | |
| Updated Policies | Experimental/Investigational Services | MA00.005ae | | 10/1/2022 | | | 10/21/2022 | Medical Coding | | Experimental/Investigational Services | |
| Updated Policies | Pneumatic Compression Therapy Devices | MA05.004e | 9/23/2022 9:00 AM | 10/24/2022 | | | 10/24/2022 | Medical Coding;General Description, Guidelines, or Informational Update | | Pneumatic Compression Therapy Devices | |
| Updated Policies | Home Oxygen Therapy | MA05.017d | | 10/24/2022 | | | 10/24/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Home Oxygen Therapy | |
| Updated Policies | Belimumab (Benlysta®) for Intravenous Use | MA08.057d | | 10/24/2022 | | | 10/24/2022 | Medical Necessity Criteria | | Belimumab (Benlysta®) for Intravenous Use | |
| Updated Policies | Chimeric Antigen Receptor (CAR) Therapy | MA08.093k | 9/28/2022 9:00 AM | 10/31/2022 | | | 10/31/2022 | Medical Necessity Criteria | | Chimeric Antigen Receptor (CAR) Therapy | |
| Reissue Policies | Golimumab (Simponi Aria®) Intravenous (IV) Injection | MA08.070e | | 12/21/2020 | 10/5/2022 | | 10/5/2022 | | | Golimumab (Simponi Aria®) Intravenous (IV) Injection | |
| Reissue Policies | Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery | MA11.056f | | 7/19/2021 | 10/5/2022 | | 10/5/2022 | | | Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery | |
| Reissue Policies | Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies | MA07.041b | | 12/16/2019 | 10/19/2022 | | 10/20/2022 | | | Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies | |
| Reissue Policies | Intravenous Chelation Therapy | MA07.016b | | 3/4/2019 | 10/19/2022 | | 10/20/2022 | | | Intravenous Chelation Therapy | |
| Reissue Policies | Transcatheter Arterial Chemoembolization (TACE) of Hepatic Malignancies | MA07.040b | | 12/2/2019 | 10/19/2022 | | 10/20/2022 | | | Transcatheter Arterial Chemoembolization (TACE) of Hepatic Malignancies | |
| Reissue Policies | Enteral Nutritional Therapy | MA08.003f | | 12/6/2021 | 10/19/2022 | | 10/20/2022 | | | Enteral Nutritional Therapy | |
| Reissue Policies | Solid Organ Transplantation and Procurement Cost of Organs and Tissues | MA11.033b | | 12/30/2017 | 10/19/2022 | | 10/20/2022 | | | Solid Organ Transplantation and Procurement Cost of Organs and Tissues | |
| Reissue Policies | Skilled Nursing Facility (SNF): Skilled and Subacute Levels of Care | MA02.004 | | 11/1/2020 | 10/19/2022 | | 10/21/2022 | | | Skilled Nursing Facility (SNF): Skilled and Subacute Levels of Care | |
| Coding Update | Preventive Care Services | MA00.003t | | 10/1/2022 | | | 10/4/2022 | | | Preventive Care Services | |
| Coding Update | Reconstructive Breast Surgery | MA11.030g | | 10/1/2022 | | | 10/5/2022 | | | Reconstructive Breast Surgery | |
| Coding Update | Endovascular Stent-Graft Repair of Thoracic Aortic Aneurysms and Nonaneurysmal Lesions | MA11.062b | | 10/1/2022 | | | 10/5/2022 | | | Endovascular Stent-Graft Repair of Thoracic Aortic Aneurysms and Nonaneurysmal Lesions | |
| Coding Update | Prophylactic Mastectomy, Oophorectomy/Salpingo-Oophorectomy, and Hysterectomy | MA11.077f | | 10/1/2022 | | | 10/5/2022 | | | Prophylactic Mastectomy, Oophorectomy/Salpingo-Oophorectomy, and Hysterectomy | |
| Coding Update | Transcatheter Aortic Valve Replacement (TAVR) and Transcatheter Mitral Valve Repair (TMVR) | MA11.027d | | 10/1/2022 | | | 10/5/2022 | | | Transcatheter Aortic Valve Replacement (TAVR) and Transcatheter Mitral Valve Repair (TMVR) | |
| Coding Update | Reimbursement for Radiopharmaceutical Agents for Professional Providers | MA09.009q | | 10/1/2022 | | | 10/10/2022 | | | Reimbursement for Radiopharmaceutical Agents for Professional Providers | |
| Coding Update | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | MA00.010ai | | 10/1/2022 | | | 10/11/2022 | | | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | |
| Coding Update | Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products | MA00.030z | | 10/1/2022 | | | 10/17/2022 | | | Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products | |
| Coding Update | Durable Medical Equipment (DME) | MA05.044m | | 10/1/2022 | | | 10/18/2022 | | | Durable Medical Equipment (DME) | |
| Archived Policies | Transtympanic Micropressure Device as a Treatment of Meniere Disease | MA05.065 | 12/31/2021 10:00 AM | 1/31/2022 | | | 10/20/2022 | | | Transtympanic Micropressure Device as a Treatment of Meniere Disease | |
