| Notifications | Reporting Requirements for Drugs and Biologics | 00.01.49f | 10/20/2023 10:00 AM | 11/20/2023 | | | 11/13/2023 | General Description, Guidelines, or Informational Update | | 11/13/2023 |
| Notifications | Reporting Requirements for Drugs and Biologics | 00.01.49f | 10/20/2023 10:00 AM | 11/20/2023 | | | 11/14/2023 | General Description, Guidelines, or Informational Update | | |
| New Policies | Tofersen (Qalsody™) | 08.02.06 | | 10/1/2023 | | | 11/6/2023 | This is a New Policy. | | |
| New Policies | Fertility Preservation (AmeriHealth New Jersey) | 07.10.08 | | 4/12/2020 | | | 11/27/2023 | This is a New Policy. | | |
| Updated Policies | Insulin Pumps and Long-Term Interstitial Continuous Glucose Monitoring Systems | 05.00.79i | | 11/1/2023 | | | 11/1/2023 | Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Short-term Interstitial Continuous Glucose Monitoring Systems (CGMS) | 05.00.24s | | 11/1/2023 | | | 11/1/2023 | Medical Necessity Criteria | | |
| Updated Policies | Musculoskeletal Services (AmeriHealth) | 00.01.66j | | 11/5/2023 | | | 11/6/2023 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding | | |
| Updated Policies | Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Therapy | 06.02.01k | | 11/6/2023 | | | 11/6/2023 | Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Experimental/Investigational Services | 12.01.01bj | | 10/1/2023 | | | 11/6/2023 | Medical Coding | | |
| Updated Policies | Intensity-Modulated Radiation Therapy (IMRT) (AmeriHealth Administrators) | 09.00.17q | | 11/6/2023 | | | 11/6/2023 | Medical Necessity Criteria | | |
| Updated Policies | Enfortumab vedotin-ejfv (Padcev®) | 08.00.43e | | 11/6/2023 | | | 11/6/2023 | Medical Necessity Criteria | | |
| Updated Policies | Tocilizumab (Actemra®) for Intravenous Infusion | 08.00.85n | 8/16/2023 10:00 AM | 11/13/2023 | | | 11/13/2023 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Direct Access to Obstetrics/Gynecology (OB/GYN) Services | 00.09.01k | | 11/13/2023 | | | 11/13/2023 | Medical Coding | | |
| Updated Policies | Full-Body Monoplace or Multiplace Chamber Hyperbaric Oxygen Therapy | 07.00.03p | | 11/15/2023 | | | 11/15/2023 | Medical Necessity Criteria | | |
| Updated Policies | Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring | 11.00.06r | | 11/15/2023 | | | 11/15/2023 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | |
| Updated Policies | Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs | 10.01.01q | | 11/15/2023 | | | 11/15/2023 | Medical Coding | | |
| Updated Policies | Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring | 07.02.21n | | 11/15/2023 | | | 11/15/2023 | Medical Coding | | |
| Updated Policies | Reporting Requirements for Drugs and Biologics | 00.01.49f | 10/20/2023 10:00 AM | 11/20/2023 | | | 11/20/2023 | General Description, Guidelines, or Informational Update | | |
| Updated Policies | Power Wheelchairs (PWCs), Power-Operated Vehicles (POVs), and Push-Rim Activated Power-Assist Devices | 05.00.54j | | 11/20/2023 | | | 11/20/2023 | General Description, Guidelines, or Informational Update | | |
| Updated Policies | Wheelchair Options and Accessories | 05.00.67s | 10/21/2023 11:00 AM | 11/20/2023 | | | 11/21/2023 | Coverage and/or Reimbursement Position;Medical Coding | | |
| Updated Policies | Daratumumab (Darzalex®), Daratumumab and Hyaluronidase-fihj (Darzalex Faspro®) | 08.01.29k | 8/29/2023 2:00 PM | 11/27/2023 | | | 11/27/2023 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | |
| Reissue Policies | Transcranial Magnetic Stimulation (TMS) | 07.03.22e | | 1/1/2023 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Reimbursement for Associated Services Performed in Conjunction with Dental Care | 00.01.18g | | 10/1/2023 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS | 00.10.18u | | 7/1/2023 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Routine Costs Associated with Qualifying Clinical Trials | 07.00.20g | | 7/5/2021 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Reporting and Documentation Requirements for Anesthesia Services | 00.01.14s | | 1/1/2022 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus | 00.10.39p | | 1/1/2023 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Hematopoietic Stem Cell Transplantation (Bone Marrow Transplant) | 11.07.01x | | 10/1/2022 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Tumor Treating Fields | 07.03.26a | | 1/27/2020 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Selective Photothermolysis Using Pulsed-Dye Lasers (PDL) | 11.08.04i | | 7/11/2022 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Intravenous Chelation Therapy | 07.00.02j | | 10/1/2023 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Pediatric Intensive Day Feeding Program | 10.00.03 | | 1/28/2019 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies | 07.05.07d | | 12/16/2019 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Telemedicine and Telehealth Services for AmeriHealth New Jersey Members | 00.10.42e | | 1/1/2023 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH) | 11.17.06q | | 7/1/2022 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Cryosurgical Ablation of the Prostate Gland | 11.11.03d | | 4/6/2015 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Procedures for the Treatment of Acne | 11.08.29e | | 10/1/2016 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) | 07.13.06m | | 10/11/2021 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Apheresis Therapy | 06.03.04n | | 1/1/2018 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Chemical Peels | 11.08.08h | | 12/26/2022 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Exon Skipping Drugs for Duchenne Muscular Dystrophy (DMD) (Eteplirsen (Exondys 51), Golodirsen (Vyondys 53), Viltolarsen (Viltepso)), Casimersen (Amondys 45) | 08.01.34c | | 10/1/2021 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Scar Revision | 11.08.25n | | 12/19/2022 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Upper Limb Prostheses | 05.00.72f | | 4/15/2019 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Transcatheter Arterial Chemoembolization (TACE) of Hepatic Malignancies | 07.05.06g | | 12/2/2019 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Radioembolization for Primary and Metastatic Tumors of the Liver | 09.00.48g | | 12/2/2019 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Breast Pumps | 05.00.76g | | 1/1/2023 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Stem-Cell Therapy/Platelet-Rich Plasma for Orthopedic Applications and Platelet-Rich Plasma/Platelet-Derived Growth Factor for Wound Healing and Other Miscellaneous Non-Orthopedic Conditions | 07.07.09i | | 7/11/2022 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Multigene Expression Assays for Predicting Recurrence in Colon Cancer (AmeriHealth Administrators) | 06.02.32d | | 7/1/2016 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Betibeglogene Autotemcel [Beti-Cel (ZYNTEGLO®)] | 08.01.89 | | 1/1/2023 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Rapid Whole Exome Sequencing (rWES) and Rapid Whole Genome Sequencing (rWGS) for Diagnosis of Genetic Disorders | 06.02.46 | | 1/1/2023 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Reconstructive Breast Surgery and Post-Mastectomy Prostheses | 11.08.15aa | | 10/1/2022 | 11/1/2023 | | 11/1/2023 | | | |
| Reissue Policies | Lutathera® (Lutetium Lu 177 Dotatate) (AmeriHealth Administrators) | 08.01.57 | | 6/28/2019 | 11/1/2023 | | 11/1/2023 | | | |
| Coding Update | Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's Disease | 08.01.93b | | 7/6/2023 | | | 11/6/2023 | | | |
| Coding Update | eviCore Lab Management (AmeriHealth) | 06.02.52ad | | 10/1/2023 | | | 11/13/2023 | | | |
| Archived Policies | Edaravone (Radicava®) | 08.01.42a | 11/15/2023 9:00 AM | 1/2/2024 | | | 11/15/2023 | | | |
| Archived Policies | Bortezomib (Bortezomib for Injection, Velcade®) | 08.00.73p | 11/15/2023 9:00 AM | 1/2/2024 | | | 11/15/2023 | | | |
