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.
11.17.06m, Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)
Notification: 09/03/2019 | Effective: 12/02/2019 | Posted: 09/03/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding; General Description, Guidelines, or Informational Update

08.00.26v, Botulinum Toxin Agents
Notification: 09/18/2019 (Revised 10/09/2019) | Effective: 12/16/2019 | Posted: 09/18/2019
Type of policy change: Medical Necessity Criteria; 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.
11.08.01g, Hair Transplants and Cranial Prostheses (Wigs)
Effective: 09/09/2019 | Posted: 09/09/2019
Type of policy change: General Description, Guidelines, or Informational Update

00.10.40d, Incident To and Non-Incident To Services Performed by Certified Registered Nurse Practitioners (CRNPs) and Physician Assistants (PAs)
Effective: 09/23/2019 | Posted: 09/23/2019
Type of policy change: General Description, Guidelines, or Informational Update

11.07.01t, Hematopoietic Stem Cell Transplantation (Bone Marrow Transplant)
Effective: 09/23/2019 | Posted: 09/23/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

08.01.38c, Ocrelizumab (Ocrevus®)
Effective: 09/23/2019 | Posted: 09/23/2019
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; General Description, Guidelines, or Informational Update

07.00.14g, Low-level Laser Therapy (LLLT)
Effective: 09/30/2019 | Posted: 09/30/2019
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.
11.00.09f, Solid Organ Transplantation and Procurement Cost of Organs and Tissues
Reissue Effective: 09/12/2019 | Reissue Posted: 09/12/2019

05.00.39o, Ankle-Foot/Knee-Ankle-Foot Orthoses
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

05.00.31e, Pulse Oximetry Devices in the Home Setting
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

08.00.57m, Treatments for Complex Regional Pain Syndrome (CRPS)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

07.11.01c, Smell and Taste Dysfunction Testing
Reissue Effective: 05/25/2019 | Reissue Posted: 09/25/2019

07.12.01e, Pelvic Floor Stimulation as a Treatment of Incontinence
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

11.14.01g, Mentoplasty or Genioplasty
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

11.08.04h, Selective Photothermolysis Using Pulsed-Dye Lasers (PDL)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

05.00.78, Transtympanic Micropressure Device as a Treatment of Meniere's Disease
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

11.08.05g, Application and Removal of Tattoos
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

08.00.75m, Erythropoiesis-Stimulating Agents (ESAs)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

08.00.95d, Personalized Vaccines (e.g. Provenge®)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

08.01.28c, Sebelipase alfa (Kanuma®)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

08.00.82j, Ustekinumab (Stelara®)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

08.00.96d, Cabazitaxel (Jevtana®)
Reissue Effective: 09/25/2019 | Reissue Posted: 09/25/2019

08.01.44c, Voretigene Neparvovec-rzyl (Luxturna™)
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

08.01.49a, Burosumab-twza (Crysvita®)
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

11.01.02n, Cochlear Implant
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

08.01.47a, Triamcinolone Acetonide Extended-Release Injectable (Zilretta™)
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

10.00.03, Pediatric Intensive Day Feeding Program
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

11.00.02f, Treatment of Medical and Surgical Complications
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

10.01.01n, Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

11.01.01j, Otoplasty or Non-Surgical External Ear Molding
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

11.08.23j, Mohs' Micrographic Surgery
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

08.01.50a, Patisiran (Onpattro™)
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

11.08.29e, Procedures for the Treatment of Acne
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

11.15.13d, Lysis of Epidural Adhesions
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

11.14.22d, Spinal Decompression with Interspinous and Interlaminar Devices
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

11.15.19e, Nucleoplasty
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

11.14.08d, Orthognathic Surgery
Reissue Effective: 09/26/2019 | Reissue Posted: 09/26/2019

07.08.01f, Non-Surgical Spinal Decompression Therapy
Reissue Effective: 09/25/2019 | Reissue Posted: 09/26/2019

11.16.08b, Implantable Steroid-Eluting Sinus Stents
Reissue Effective: N/A | Reissue Posted: 09/26/2019

07.03.24, Laboratory-Based Vestibular Function Testing
Reissue Effective: 09/25/2019 | Reissue Posted: 09/26/2019

11.08.08g, Chemical Peels
Reissue Effective: 09/25/2019 | Reissue Posted: 09/26/2019


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.
11.03.12r, Colorectal Cancer Screening
Effective: 07/01/2019 | Posted: 09/10/2019

09.00.04j, Bone Mineral Density (BMD) Testing
Effective: 07/01/2019 | Posted: 09/10/2019

06.02.17f, Serodiagnosis of Inflammatory Bowel Disease (IBD) and the Prometheus® IBD sgi Diagnostic™ Test
Effective: 07/01/2019 | Posted: 09/10/2019

06.02.44j, Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
Effective: 07/01/2019 | Posted: 09/10/2019

06.02.35u, Genetic Testing (AmeriHealth Administrators)
Effective: 07/01/2019 | Posted: 09/10/2019