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.
06.02.52j, eviCore Lab Management Program (AmeriHealth)
Notification: 06/01/2018 (Revised 06/29/2018) | Effective: 07/02/2018 | Posted: 06/01/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

08.00.73j, Bortezomib (Bortezomib for Injection, Velcade®)
Notification: 06/08/2018 | Effective: 07/09/2018 | Posted: 06/08/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

11.01.01j, Otoplasty or Non-Surgical External Ear Molding
Notification: 06/12/2018 | Effective: 09/10/2018 | Posted: 06/12/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

07.13.06k, Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Notification: 06/13/2018 | Effective: 09/10/2018 | Posted: 06/13/2018
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

11.15.03j, Insertion of Implantable Infusion Pumps
Notification: 06/27/2018 | Effective: 07/30/2018 | Posted: 06/27/2018
Type of policy change: Medical Necessity Criteria

09.00.56f, Radiation Therapy Services (AmeriHealth)
Notification: 06/29/2018 (revised 07/26/2018) | Effective: 10/01/2018 | Posted: 06/29/2018
Type of policy change: Medical Coding; General Description, Guidelines, or Informational Update


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.
08.01.01g, Ipilimumab (Yervoy®)
Effective: 06/04/2018 | Posted: 06/04/2018
Type of policy change: Medical Necessity Criteria; General Description, Guidelines, or Informational Update

11.00.06h, Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring for Adults
Effective: 06/18/2018 | Posted: 06/18/2018
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

07.08.03d, Medical and Surgical Treatment of Temporomandibular Joint Disorder
Effective: 06/25/2018 | Posted: 06/25/2018
Type of policy change: Coverage and/or Reimbursement Position


Reissue Policies
The following commercial policies have been reviewed, and no substantive changes were made.
07.03.07q, Evaluation and Management of Autism Spectrum Disorders (ASD)
Reissue Effective: 06/06/2018 | Reissue Posted: 06/06/2018

11.16.07b, Bronchial Thermoplasty
Reissue Effective: 06/06/2018 | Reissue Posted: 06/06/2018

07.03.03f, Medical Evaluation and Management for Attention-Deficit Hyperactivity Disorder (ADHD)
Reissue Effective: 06/06/2018 | Reissue Posted: 06/06/2018

10.00.02b, Day Rehabilitation
Reissue Effective: 06/06/2018 | Reissue Posted: 06/06/2018

01.00.09c, Continuous Local Delivery of Anesthesia to Operative Sites Using an Elastomeric Infusion Pump
Reissue Effective: 06/06/2018 | Reissue Posted: 06/07/2018

07.02.09e, Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices
Reissue Effective: 06/06/2018 | Reissue Posted: 06/07/2018

07.06.03b, Bioimpedance for the Detection of Lymphedema
Reissue Effective: 06/06/2018 | Reissue Posted: 06/07/2018

10.04.01k, Pulmonary Rehabilitation
Reissue Effective: 06/06/2018 | Reissue Posted: 06/07/2018

02.01.01d, Home Health Care Services
Reissue Effective: 06/06/2018 | Reissue Posted: 06/07/2018

08.01.19e, Siltuximab (Sylvant®)
Reissue Effective: 06/15/2018 | Reissue Posted: 06/15/2018
Type of policy change: Medical Necessity Criteria

08.01.28b, Sebelipase alfa (Kanuma®)
Reissue Effective: 06/15/2018 | Reissue Posted: 06/15/2018

08.01.22c, Alemtuzumab (Lemtrada™)
Reissue Effective: 06/15/2018 | Reissue Posted: 06/15/2018

08.00.72g, Alglucosidase alfa (e.g., Lumizyme®)
Notification: 12/22/2017 | Reissue Effective: 06/15/2018 | Reissue Posted: 06/15/2018

08.01.39a, Cerliponase alfa (Brineura™)
Reissue Effective: 06/15/2018 | Reissue Posted: 06/15/2018

08.01.26, Pegademase bovine (Adagen®)
Reissue Effective: 06/15/2018 | Reissue Posted: 06/15/2018

08.00.69a, Agalsidase beta (Fabrazyme®)
Reissue Effective: 06/15/2018 | Reissue Posted: 06/15/2018

07.06.01b, Complete Decongestive Therapy (CDT)
Reissue Effective: 06/20/2018 | Reissue Posted: 06/20/2018

11.05.10b, Reimbursement for a Presbyopia- or Astigmatism-Correcting Intraocular Lens
Reissue Effective: 06/20/2018 | Reissue Posted: 06/20/2018

05.00.38j, Negative-Pressure Wound Therapy (NPWT) Systems
Reissue Effective: 06/20/2018 | Reissue Posted: 06/20/2018

11.11.01i, Evaluation and Treatment of Erectile Dysfunction (ED)
Reissue Effective: 06/20/2018 | Reissue Posted: 06/20/2018

07.00.01h, Biofeedback Therapy
Reissue Effective: 06/20/2018 | Reissue Posted: 06/20/2018

02.02.01g, Hospice Care
Reissue Effective: 06/20/2018 | Reissue Posted: 06/20/2018

07.07.07f, Electrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds
Reissue Effective: 06/20/2018 | Reissue Posted: 06/21/2018


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.
08.00.92w, Coagulation Factors
Effective: 07/01/2018 | Posted: 06/29/2018

08.00.78z, Self-Administered Drugs
Effective: 07/01/2018 | Posted: 06/29/2018

08.01.44a, Voretigene Neparvovec-rzyl (Luxturna)
Effective: 07/01/2018 | Posted: 06/29/2018