Commercial
  
  
  
  
  
  
  
  
  
  
Notificationscrizanlizumab-tmca (Adakveo®)08.00.049/1/2020 12:00 PM11/30/20209/1/2020This is a New Policy.9/21/2020
NotificationsSkilled Nursing Facility (SNF): Skilled and Subacute Levels of Care02.03.009/1/2020 12:00 PM10/1/20209/1/2020This is a New Policy.9/18/2020
NotificationsMedical and Surgical Treatment of Temporomandibular Joint Disorder07.08.03f9/1/2020 12:00 PM11/30/20209/1/2020Medical Coding
NotificationsTrigger Point Injections11.14.02p9/1/2020 12:00 PM11/30/20209/1/2020Medical Necessity Criteria;General Description, Guidelines, or Informational Update
NotificationsEculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris®)08.00.84h9/1/2020 3:00 PM11/30/20209/1/2020Coverage and/or Reimbursement Position
New Policieslurbinectedin (Zepzelca)08.01.679/14/20209/14/2020This is a New Policy.
New PoliciesInebilizumab-cdon (Uplizna)08.01.689/14/20209/14/2020This is a New Policy.
Updated PoliciesPercutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound  (AmeriHealth)11.02.27c 11/10/20199/14/2020General Description, Guidelines, or Informational Update
Updated PoliciesIpilimumab (Yervoy®)08.01.01j9/14/20209/14/2020Medical Necessity Criteria
Updated PoliciesImmunizations08.01.04w9/14/20209/14/2020Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesNivolumab (Opdivo®)08.01.629/14/20209/14/2020Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update
Updated PoliciesAvelumab (Bavencio®)08.01.649/14/20209/14/2020Medical Necessity Criteria
Updated PoliciesPembrolizumab (Keytruda®)08.01.639/14/20209/14/2020Medical Necessity Criteria
Updated PoliciesDurvalumab (Imfinzi™)08.01.659/14/20209/14/2020Medical Necessity Criteria
Reissue PoliciesRoutine Foot Care for Certain Medical Conditions07.07.01o10/1/20198/26/20209/3/2020
Reissue PoliciesExternal Counterpulsation (ECP)07.02.05j 9/30/20168/26/20209/3/2020
Reissue PoliciesImplantable Steroid-Eluting Sinus Stents11.16.08d7/1/20208/26/20209/3/2020
Reissue PoliciesLaboratory-Based Vestibular Function Testing07.03.24a10/1/20199/11/20209/11/2020
Reissue PoliciesMentoplasty or Genioplasty11.14.01g6/30/20179/11/20209/11/2020
Reissue PoliciesLysis of Epidural Adhesions11.15.13d2/24/20169/11/20209/11/2020
Reissue PoliciesMigraine Deactivation Surgery11.15.24a3/11/20159/11/20209/11/2020
Reissue PoliciesNucleoplasty11.15.19e5/7/20149/11/20209/11/2020
Reissue PoliciesEdaravone (Radicava™)08.01.42a1/1/20199/11/20209/11/2020
Reissue PoliciesMedical Evaluation and Management for Attention-Deficit Hyperactivity Disorder (ADHD)07.03.03g7/15/20199/24/20209/24/2020
Reissue PoliciesTranscranial Magnetic Stimulation (TMS)07.03.22d7/1/20199/24/20209/24/2020
Reissue PoliciesTotal Artificial Hearts (TAHs)11.02.19f1/1/20199/24/20209/24/2020
Reissue PoliciesPediatric Intensive Day Feeding Program10.00.031/28/20199/24/20209/24/2020
Reissue PoliciesMagnetoencephalography (MEG) with Magnetic Source Imaging (MSI)07.03.10e1/28/20159/24/20209/24/2020
Reissue PoliciesPercutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation11.02.26b10/1/20199/23/20209/25/2020
Reissue PoliciesElectron Beam Computed Tomography (EBCT) for Screening Evaluations09.00.02e3/15/20159/23/20209/25/2020
Reissue PoliciesFull-Body Computerized Tomography (CT) Scan Screening09.00.24c3/25/20159/23/20209/25/2020
Reissue PoliciesTranscatheter Closure of Cardiac Septal Defects11.02.11g11/17/20179/23/20209/25/2020