Back brace codes not listed in Medical policy statement are considered not medically necessary and therefore are not covered. Added diagnosis for coverage of back braces.
BI580 New
Emergency Department Care
01/01/19
New --- Added K59.00- K59.09: Constipation will be denied/pended for medical record review.
Coming Amendments
Medical Policy Number
Medical Policy Name
Effective Date of Change
Description of Changes
BI306 V
Obstructive Sleep Apnea
02/01/19
Eliminated accreditation requirements for HSTs.
BI363 V
Balloon Sinuplasty
02/01/19
Balloon dilation of Eustachian tube considered experimental and/or investigational.
For urgent questions about QualChoice Medical Coverage Policies, please fax a completed Predetermination Request Form for each patient to 844.501.2830.