Site Activity
This page provides a monthly listing of publication activity on the Medical Policy Portal including Policy Notifications, New Policies, Updated Policies, Coding Updates, Reissued Policies, and Archived Policies. To view publication activity from prior months, select Past Site Activity.

Past Site Activity

 
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Notifications
The following AmeriHealth commercial policies have been posted prior to their effective date.
06.02.50, GPS Cancer™ Testing by NantHealth
Notification: 02/03/2016 | Effective: 03/01/2016 | Posted: 02/03/2016
Type of policy change: This is a new policy.


New Policies
The following commercial policies have been newly developed to communicate coverage and/or reimbursement positions, reporting requirements, and other processes and procedures for doing business with AmeriHealth.
06.02.45, Vectra® DA Blood Test for Rheumatoid Arthritis
Effective: 02/01/2016 | Posted: 02/01/2016
Type of policy change: This is a new policy.

11.16.08, Implantable Steroid-Eluting Sinus Stents
Notification: 11/06/2015 | Effective: 02/04/2016 | Posted: 02/04/2016
Type of policy change: This is a new policy.

08.01.28, Sebelipase alfa (Kanuma®)
Effective: 02/24/2016 | Posted: 02/24/2016
Type of policy change: This is a new policy.


Updated Policies
The following commercial policies have been reviewed and updated to communicate current coverage and/or reimbursement positions, reporting requirements, and other procedures for doing business with AmeriHealth.
11.02.25d, Transcatheter Aortic-Valve Replacement (TAVR) and Transcatheter Mitral Valve Repair (TMVR)
Effective: 02/03/2016 | Posted: 02/03/2016
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

08.00.75k, Erythropoiesis-Stimulating Agents (ESAs)
Notification: 01/11/2016 | Effective: 02/08/2016 | Posted: 02/08/2016

11.02.01k, Treatment of Varicose Veins of the Lower Extremities and Perforator Vein Incompetence
Notification: 01/11/2016 | Effective: 02/10/2016 | Posted: 02/10/2016
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

11.15.13d, Lysis of Epidural Adhesions
Effective: 02/24/2016 | Posted: 02/24/2016
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

12.01.01af, Experimental/Investigational Services
Effective: 01/03/2016 | Posted: 02/24/2016


Reissue Policies
The following commercial policies have been reviewed, and no substantive changes were made.
08.00.70b, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase™, Vimizim™, Naglazyme®, etc.)
Reissue Effective: 02/03/2016 | Reissue Posted: 02/03/2016

08.01.18b, Vedolizumab (Entyvio®)
Reissue Effective: 02/03/2016 | Reissue Posted: 02/03/2016

11.00.03i, Fetal Surgery
Reissue Effective: 02/03/2016 | Reissue Posted: 02/03/2016

11.15.19e, Nucleoplasty
Reissue Effective: 02/17/2016 | Reissue Posted: 02/17/2016

11.15.16k, Vagus Nerve Stimulation (VNS)
Reissue Effective: 02/17/2016 | Reissue Posted: 02/17/2016

11.15.01p, Spinal Cord Stimulation (Dorsal Column Stimulation)
Reissue Effective: 02/03/2016 | Reissue Posted: 02/17/2016

07.03.21g, Electromyography (EMG) (Needle and Non-Needle) of the Anal or Urethral Sphincter
Reissue Effective: 02/03/2016 | Reissue Posted: 02/17/2016

05.00.14g, High-Frequency Chest Wall Oscillation Devices
Reissue Effective: 02/16/2016 | Reissue Posted: 02/18/2016

09.00.40d, Screening for Vertebral Fracture with Dual-Energy X-ray Absorptiometry (DEXA/DXA)
Reissue Effective: 02/17/2016 | Reissue Posted: 02/19/2016

09.00.04g, Bone Mineral Density (BMD) Testing
Reissue Effective: 02/18/2016 | Reissue Posted: 02/19/2016

11.06.09b, Labiaplasty
Reissue Effective: 02/17/2016 | Reissue Posted: 02/19/2016


Coding Update
The following commercial policies have been reviewed and updated to add new and revised medical codes (e.g., ICD-9 and ICD-10 diagnosis codes; CPT® and HCPCS codes; revenue codes) and/or remove terminated medical codes.
05.00.39l, Ankle-Foot/Knee-Ankle-Foot Orthoses
Effective: 01/01/2016 | Posted: 02/04/2016

00.03.09b, X-rays Associated with Fractures in the Office Setting
Effective: 01/01/2016 | Posted: 02/05/2016

00.10.32d, Prolonged Face-to-Face Physician Services
Effective: 01/01/2016 | Posted: 02/05/2016

09.00.23c, Therapeutic Radiology Port Films
Effective: 01/01/2016 | Posted: 02/05/2016

09.00.32n, Diagnostic and Therapeutic Radiopharmaceutical Agents
Effective: 01/01/2016 | Posted: 02/05/2016

00.10.36m, Radiologic Guidance of a Procedure
Effective: 01/01/2016 | Posted: 02/05/2016

06.02.30d, Pharmacogenetic Testing to Determine Drug Sensitivity
Effective: 01/01/2016 | Posted: 02/19/2016

06.02.35i, Genetic Testing
Effective: 01/01/2016 | Posted: 02/19/2016