Medical Policy Number
|
Medical Policy Name |
Effective Date of Change |
Description of Changes |
BI032
|
Complications of Non-Covered Care
|
08/01/18 |
Retired policy.
|
BI104 |
Anesthesia for Dental Procedures |
08/01/18 |
Clarification of types of eligible dental services.
|
BI169 |
Macular Degeneration Treatments and Diabetic Macular Edema Treatments |
08/01/18
|
Clarifed difference between low-dose bevacizumab for ocular disease and high-dose bevacizumab for patients with cancer or HHT.
|
BI299 |
Avastin |
08/01/18 |
Clarified difference between low-dose bevacizumab for ocular disease and high-dose bevacizumab for patients with cancer or HHT.
|
|
Impella |
08/01/18 |
Noted expanded FDA indications for Impella but no change in E/I exclusions. |
BI029 |
UV Light Therapy |
09/01/18 |
UVB device code range updated. |
BI040 |
Eating Disorders |
09/01/18 |
Retired policy.
|
BI055 |
Midwife |
09/01/18 |
Configured for different lines of business. |
BI062 |
Preventive Health Benefit |
09/01/18 |
Table Update: Administration of ocular topical medication is part of hospital care; separately reimbursable. Covered as preventive for members up to 90 days of age: V5008, 92551, 92558, 925865-92588, 84437, 84443, 84030, S3850, 83020, 83021. If billed otherwise, covered under medical benefit.
|
BI091 |
Compression Devices |
09/01/18 |
Codes updated for ease of searching. |
BI162 |
Urinary Incontinence Treatments |
09/01/18 |
Additional procedure codes updated.
|
BI182 |
Intervertebral Disc Prostheses |
09/01/18 |
Clarified that CPT codes 22853, 22854 and 22859 (insertion of intervertebral disc placement) also require pre-authorization. |
BI380 |
Relistor |
09/01/18 |
Updated to note Relistor tablets are not covered.
|
BI381 |
Intraoperative Neurophysiologic Monitoring |
09/01/18 |
Updated configuration for additional remote monitoring code and for dual purpose test (limited auditory evoked potentials). |
BI382 |
Bio-Engineered Skin and Soft Tissue Substitutes |
09/01/18 |
Added Grafix for diabetic lower extremity ulcers.
|
BI332 |
Monitored Anesthesia |
Current
|
Added clear coding and billing requirements for coverage of monitored anesthesia for providers. |
BI534 |
Back Braces |
Current
|
Updated HCPCS codes for covered back braces in Medical Policy Statement.
|