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News & AnnouncementsCoverage of the COVID-19 Vaccination for AmeriHealth Members (Retroactively effective to December 8, 2022.  Updated January 20, 2023)1/20/2023
Updated PoliciesNoninvasive Respiratory Assist Devices (RADs): Continuous Positive Airway Pressure (CPAP) Devices, Auto-Adjusting Positive Airway Pressure (A​PAP) and Bi-Level Devices05.00.30n12/2/2022 9:00 AM1/2/20231/2/2023Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesNeuromuscular Electrical Stimulators (NMES) and Functional Electrical Stimulators (FES)05.00.73f12/2/2022 1:00 PM1/2/20231/3/2023Coverage and/or Reimbursement Position;Medical Coding
Updated PoliciesBreast Pumps05.00.76g1/1/20231/4/2023Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesExperimental/Investigational Services12.01.01bg1/1/20231/11/2023Medical Coding
Updated PoliciesInsertion of Implantable Infusion Pumps11.15.03l12/16/2022 9:00 AM1/16/20231/25/2023Medical Coding;General Description, Guidelines, or Informational Update1/25/2023
Reissue PoliciesNoninvasive Prenatal Screening for Fetal Aneuploidies Using Cell-Free Fetal DNA (AmeriHealth Administrators)06.02.47e10/1/20211/25/20231/25/2023
Reissue PoliciesCobalamin (Vitamin B12), Folic Acid, and Homocysteine Testing06.02.54c10/1/20221/25/20231/25/2023
Reissue PoliciesMeasurement of Exhaled Nitric Oxide and Breath Condensate in the Diagnosis and Management of Asthma and Other Respiratory Disorders07.11.02f3/26/20181/25/20231/25/2023
Reissue PoliciesTesting Serum Vitamin D Levels06.02.51d10/1/20201/25/20231/25/2023
Reissue PoliciesVedolizumab (Entyvio®)08.01.18f7/12/20211/25/20231/25/2023
Coding UpdateTreatments for Complex Regional Pain Syndrome (CRPS)08.00.57p1/1/20231/1/2023
Coding UpdateRadiation Therapy Services (AmeriHealth)09.00.56p1/1/20231/3/2023
Coding UpdateGender Affirming Interventions11.09.02l1/1/20231/3/2023
Coding UpdateBone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids11.01.06g1/1/20231/3/2023
Coding UpdateSentinel Lymph Node Biopsy and Mapping11.07.02k1/1/20231/3/2023
Coding UpdateCriteria for Reimbursement of Emergency Room Services00.10.03k1/1/20231/4/2023
Coding UpdateModifiers 26 (Professional Component) and TC (Technical Component)03.00.20p1/1/20231/4/2023
Coding UpdateReimbursement for the Administration of Drugs, Substances, and/or Biologic Agents00.10.43b1/1/20231/4/2023
Coding UpdatePsychiatric Collaborative Care Management (CoCM) (AmeriHealth)00.01.70a1/1/20231/4/2023
Coding UpdateImmune Globulin Intravenous (IVIG), Subcutaneous (SCIG)08.00.13ae10/1/20221/5/20231/5/2023
Coding UpdateModifier 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 Service03.00.06w1/1/20231/6/2023
Coding UpdatePercutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound  (AmeriHealth)11.02.27g1/1/20231/6/20231/6/2023
Coding UpdateAlways Bundled Procedure Codes00.01.52r1/1/20231/9/2023
Coding UpdateModifier 62: Two Surgeons00.10.11u1/1/20231/12/2023
Coding UpdateModifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS00.10.18t1/1/20231/13/2023