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News & AnnouncementsNotice of Withdrawal of Advance Notification of Future Policy #00.10.41h: Telemedicine Services11/25/2020
News & AnnouncementsVeklury® (remdesivir) and Bamlanivimab® (LY-CoV555) for COVID-19 Treatment for AmeriHealth Pennsylvania Commercial Members11/25/2020
News & AnnouncementsVeklury® (remdesivir) and Bamlanivimab® (LY-CoV555) for COVID-19 Treatment for AmeriHealth New Jersey Commercial Members11/25/2020
New PoliciesSkilled Nursing Facility (SNF): Skilled and Subacute Levels of Care02.03.009/1/2020 12:00 PM11/1/202011/1/2020This is a New Policy.
New Policiescrizanlizumab-tmca (Adakveo®)08.00.049/1/2020 12:00 PM11/30/202011/30/2020This is a New Policy.
New PoliciesCollagenase clostridium histolyticum ( Xiaflex ®), collagenase clostridium histolyticum-aaes (Qwo™)08.01.7111/30/202011/30/2020This is a New Policy.
New PoliciesPertuzumab, Trastuzumab, and Hyaluronidase-zzxf (PhesgoTM)08.01.7211/30/202011/30/2020This is a New Policy.
Updated PoliciesPressure-Reducing Support Surfaces05.00.60i10/9/2020 2:00 PM11/9/202011/9/2020Medical Necessity Criteria
Updated PoliciesCervical Traction Devices for In-home Use05.00.61g11/9/202011/9/2020General Description, Guidelines, or Informational Update
Updated PoliciesCarfilzomib (Kyprolis®)08.01.05g11/16/202011/16/2020Medical Necessity Criteria
Updated PoliciesTherapeutic Shoes and Orthopedic Shoes05.00.11j 10/23/2020 2:00 PM11/23/202011/23/2020Medical Necessity Criteria
Updated PoliciesCosmetic Procedures12.01.03a11/23/202011/23/2020Coverage and/or Reimbursement Position;General Description, Guidelines, or Informational Update
Updated PoliciesHigh-Technology Radiology Services (AmeriHealth)09.00.46ad11/23/202011/23/2020Medical Coding
Updated PoliciesTrigger Point Injections11.14.02p9/1/2020 12:00 PM11/30/202011/30/2020Medical Necessity Criteria;General Description, Guidelines, or Informational Update
Updated PoliciesAqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma11.05.16i11/30/202011/30/2020Medical Coding
Updated PoliciesGastric Electrical Stimulation (Enterra™), Gastric Pacing11.03.15i11/30/202011/30/2020Medical Coding
Updated PoliciesMedical and Surgical Treatment of Temporomandibular Joint Disorder07.08.03g9/1/2020 4:00 PM11/30/202011/30/2020Coverage and/or Reimbursement Position
Reissue PoliciesDrug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies07.05.07d12/16/201911/4/202011/4/2020
Reissue PoliciesMohs' Micrographic Surgery11.08.23j10/1/201811/5/202011/5/2020
Reissue PoliciesRadiofrequency Ablation and Cryosurgical Ablation of Lung Tumors11.00.16g4/9/201811/4/202011/9/2020
Reissue PoliciesApplication and Removal of Tattoos11.08.05g7/20/201211/9/202011/9/2020
Reissue PoliciesMechanical Stretching Devices for the Treatment of Joint Stiffness or Contractures05.00.70b8/26/201611/4/202011/10/2020
Reissue PoliciesSolid Organ Transplantation and Procurement Cost of Organs and Tissues11.00.09f1/1/201811/4/202011/10/2020
Reissue PoliciesPartial Coherence Interferometry07.13.08e4/23/201811/18/202011/18/2020
Reissue PoliciesColorectal Cancer Screening11.03.12s4/1/202011/18/202011/18/2020
Reissue PoliciesContact Lenses for the Treatment of Persistent (Corneal) Epithelial Defects07.13.11j10/1/202011/18/202011/18/2020
Reissue PoliciesCorneal Pachymetry Using Ultrasound07.13.07k10/1/202011/18/202011/18/2020
Reissue PoliciesBiofeedback Therapy07.00.01j10/1/202011/18/202011/18/2020
Reissue PoliciesPhotodynamic Therapy (PDT) Using Verteporfin (Visudyne®)07.13.05k5/7/201811/18/202011/20/2020
Reissue PoliciesFecal Microbiota Transplantation (FMT)07.05.08a10/1/201711/18/202011/20/2020
Reissue PoliciesIslet Cell Transplantation11.04.01d1/1/202011/18/202011/20/2020
Reissue PoliciesOrthoptic/Pleoptic Training07.13.01h10/7/201911/18/202011/20/2020
Reissue PoliciesEndovascular Stent-Graft Repair of Thoracic Aortic Aneurysms and Nonaneurysmal Lesions11.02.17f3/26/201811/18/202011/20/2020
Reissue PoliciesCatheter Ablation of Cardiac Arrhythmias11.02.06m10/1/201911/18/202011/20/2020
Reissue PoliciesFull-Body Monoplace or Multiplace Chamber Hyperbaric Oxygen Therapy07.00.03n12/1/201611/18/202011/20/2020
Reissue PoliciesChemical Peels11.08.08g12/16/201511/18/202011/20/2020
Reissue PoliciesNatalizumab (Tysabri®)08.00.64g10/21/201911/18/202011/20/2020
Reissue PoliciesPanniculectomy, Abdominoplasty, and Other Excisions of Redundant Skin11.08.06j10/1/201811/18/202011/20/2020
Coding UpdateGenetic Testing (AmeriHealth Administrators)06.02.35z10/1/202011/3/2020
Coding UpdateeviCore Lab Management Program (AmeriHealth)06.02.52r10/1/202011/3/2020
Coding UpdatePPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services00.01.25az10/1/202011/24/2020
Coding UpdateLaboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products00.03.07aa10/1/202011/24/2020