Provider Quick Alert

July 1, 2020
Review all  Medical Coverage Policies at QualChoice.com.
New and Amended Medical Policies
P = Payment Change
C = Code Change
V = Verbiage Change

Medical Policy Number
Medical Policy Name Effective Date of Change Description of Changes
BI038   C
Genetic Testing 07/01/20 Red cell antigen genotyping (0180U - 201U) requires pre-authorization.
BI062  V, C
Preventive Health Benefit
07/01/20
No longer require Z790.1 Dx for Cologuard.
BI089   V
Infliximab 07/01/20 Explicit renewal criteria for Remicade PA.
BI111   C
Allergy Testing
07/01/20
Added new code (0178U) with pre-authorization.
BI122   C
Optic Nerve and Retinal Imaging 07/01/20 New E/I codes added for home (patient-initiated) OCT.
BI162  C
Urinary Incontinence Treatments
07/01/20
New E/I codes added for temporary female intraurethral valve-pump.
BI182  C
Invertebral Disc Prostheses
07/01/20
New E/I codes added (0609T - 0612T).
BI186  C
Radiofrequency Ablation 07/01/20 New E/I codes added for irreversible electroporation (NanoKnife).
BI196   C
Stereotactic Radiosurgery 07/01/20 HCPCs codes G0339 and G0340 were added and require pre-authorization.
BI254  C
Intraocular Lenses
07/01/20
Added new codes for iris prosthesis (0616T-0618T); not covered.
BI265   C
Cardioverter Defibrillator 07/01/20 Added new code 0614T.
BI348   V
Dorsal Column Stimulator
07/01/20
Explicit clarification of what constitutes failure of all other therapies.
BI382   C
Bioengineered Skin and Soft Tissue Substitutes 07/01/20 New codes added (C1849, Q4227-Q4249, 0598T and 0599T); experimental.
BI394  C
Spinal Surgery
07/01/20
New E/I codes (0609T-0612T) added.
BI508  C
BRCA Testing
07/01/20
New E/I codes (0609T-0612T) added.
BI529  C
Telemedicine Payment Policy 07/01/20 New E/I codes (0607T, 0608T) added.
Comi ng Amendments

Medical Policy Number
Medical Policy Name Effective Date of Change Description of Changes
BI345 V
Testing for Drugs of Abuse 09/01/20 Presumptive drug testing (CPT 80305-80306) is covered not more than once per day, or twice per month and 24 times per 12 months. Confirmatory drug testing is also covered once per day, up to twice per month and 24 times per 12 months.
For questions about QualChoice Medical Coverage Policies, please contact your Provider Relations Representative 
 at 800.235.7111 or 501.228.7111, ext. 7004, Monday through Friday, 8:00 a.m. to 5:00 p.m.

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