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.
03.00.06n, Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
Notification: 05/01/2017 (revised 05/09/2017 and 07/24/2017) | Effective: 08/01/2017 | Posted: 05/01/2017
Type of policy change: Coverage and/or Reimbursement Position; General Description, Guidelines, or Informational Update

08.00.88d, Ofatumumab (Arzerra™)
Notification: 05/01/2017 | Effective: 05/29/2017 | Posted: 05/01/2017
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

11.14.30, Composite Tissue Allotransplantation of the Hand(s) and Face
Notification: 05/03/2017 | Effective: 06/02/2017 | Posted: 05/03/2017
Type of policy change: This is a new policy.

07.03.23, Autonomic Nervous System Testing
Notification: 05/03/2017 | Effective: 08/01/2017 | Posted: 05/03/2017
Type of policy change: This is a new policy.

11.01.01j, Otoplasty or Non-Surgical External Ear Molding
Notification: 05/17/2017 (removed 08/14/2017) | Effective: 08/15/2017 | Posted: 05/17/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

00.06.02t, Preventive Care Services (AmeriHealth)
Notification: 05/31/2017 | Effective: 07/01/2017 | Posted: 05/31/2017
Type of policy change: Medical Necessity Criteria; Medical Coding


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.
11.08.01f, Hair Transplants and Cranial Prostheses (Wigs)
Effective: 05/03/2017 | Posted: 05/03/2017
Type of policy change: General Description, Guidelines, or Informational Update

08.01.18c, Vedolizumab (Entyvio®)
Notification: 04/05/2017 | Effective: 05/05/2017 | Posted: 05/05/2017
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

08.01.19e, Siltuximab (Sylvant®)
Effective: 05/17/2017 | Posted: 05/17/2017
Type of policy change: Medical Necessity Criteria

08.00.57k, Complex Regional Pain Syndrome (CRPS) Parenteral Treatments
Effective: 05/17/2017 | Posted: 05/17/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

11.08.03j, Lipectomy and Liposuction
Effective: 05/19/2017 | Posted: 05/19/2017
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

11.08.13g, Rhytidectomy and/or Cervicoplasty With or Without Liposuction and/or Platysmaplasty
Effective: 05/19/2017 | Posted: 05/19/2017
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update

08.00.88d, Ofatumumab (Arzerra™)
Notification: 05/01/2017 | Effective: 05/29/2017 | Posted: 05/26/2017
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

08.00.25i, Treatment of Pulmonary Artery Hypertension with Intravenous, Subcutaneous, and Inhaled Pharmacologic Agents
Notification: 04/26/2017 | Effective: 05/26/2017 | Posted: 05/26/2017
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

08.00.78v, Self-Administered Drugs
Effective: 05/31/2017 | Posted: 05/31/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding

08.00.75l, Erythropoiesis-Stimulating Agents (ESAs)
Effective: 05/31/2017 | Posted: 05/31/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update


Reissue Policies
The following commercial policies have been reviewed, and no substantive changes were made.
05.00.09h, Electrical Bone Growth Stimulation and Low-Intensity Ultrasound Accelerated Fracture Healing System
Reissue Effective: 05/10/2017 | Reissue Posted: 05/10/2017

05.00.72d, Upper Limb Prostheses
Reissue Effective: 05/10/2017 | Reissue Posted: 05/10/2017

12.04.03b, Air or Sea Ambulance Transport Services
Reissue Effective: 05/10/2017 | Reissue Posted: 05/10/2017

11.15.13d, Lysis of Epidural Adhesions
Reissue Effective: 05/10/2017 | Reissue Posted: 05/10/2017

05.00.24n, Interstitial Continuous Glucose Monitoring Systems (CGMSs)
Reissue Effective: 05/10/2017 | Reissue Posted: 05/10/2017

10.00.02b, Day Rehabilitation
Reissue Effective: 05/24/2017 | Reissue Posted: 05/25/2017

11.15.24a, Migraine Deactivation Surgery
Reissue Effective: 05/24/2017 | Reissue Posted: 05/25/2017

10.06.01j, Speech Therapy
Reissue Effective: 05/24/2017 | Reissue Posted: 05/25/2017


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.
06.02.35m, Genetic Testing (AmeriHealth Administrators)
Effective: 05/01/2017 | Posted: 05/01/2017

06.02.52d, eviCore Lab Management Program (AmeriHealth)
Effective: 05/01/2017 | Posted: 05/01/2017