Aetna January 2018 Medical Policy Updates

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January 2018

New:

January 2, 2018 – 0924 – Axicabtagene Ciloleucel (Yescarta)

Revised:

January 17, 2018 – 0016 – Back Pain – Invasive Procedures
January 17, 2018 – 0115 – Varicella and Herpes Zoster Vaccines
January 17, 2018 – 0227 – BRCA Testing, Prophylactic Mastectomy, and Prophylactic Oophorectomy
January 17, 2018 – 0322 – Electroencephalographic (EEG) Video Monitoring
January 17, 2018 – 0352 – Tumor Markers
January 17, 2018 – 0591 – Intervertebral Disc Prostheses
January 17, 2018 – 0743 – Spinal Surgery: Laminectomy and Fusion
January 17, 2018 – 0890 – Pembrolizumab (Keytruda)
January 5, 2018 – 0404 – Interferons
January 5, 2018 – 0654 – Ventricular Assist Devices
January 5, 2018 – 0677 – Functional Electrical Stimulation and Neuromuscular Electrical Stimulation
January 5, 2018 – 0878 – Naltrexone Implants
January 5, 2018 – 0879 – Quantitative Pupillometry/Pupillography
January 5, 2018 – 0880 – Percutaneous Mitral Valve Repair
January 5, 2018 – 0881 – Canakinumab (Ilaris)
January 5, 2018 – 0882 – Metreleptin (Myalept)
January 5, 2018 – 0883 – Ramucirumab (Cyramza)
January 5, 2018 – 0884 – Siltuximab (Sylvant)
January 5, 2018 – 0885 – Vedolizumab (Entyvio)
January 5, 2018 – 0886 – Optical Coherence Tomography and Microelastography for Solid Tumors and Other Selected Indications
January 5, 2018 – 0887 – Belinostat (Beleodaq)
January 5, 2018 – 0888 – Radiostereometric Analysis for Migration and Wear of Orthopedic Implants
January 5, 2018 – 0889 – Levoleucovorin (Fusilev)
January 5, 2018 – 0891 – Blinatumomab (Blincyto)
January 5, 2018 – 0893 – Leadless Cardiac Pacemaker
January 5, 2018 – 0894 – Recombinant Human Parathyroid Hormone (Natpara)
January 5, 2018 – 0895 – Dinutuximab (Unituxin)
January 5, 2018 – 0897 – Mepolizumab (Nucala)
January 5, 2018 – 0899 – Elotuzumab (Empliciti)
January 5, 2018 – 0900 – Talimogene Laherparepvec (Imlygic)
January 5, 2018 – 0902 – Irinotecan Liposome Injection (Onivyde)
January 5, 2018 – 0903 – Trabectedin (Yondelis)
January 5, 2018 – 0904 – Daratumumab (Darzalex)
January 5, 2018 – 0907 – Reslizumab (Cinqair)
January 5, 2018 – 0908 – Vincristine Sulfate Liposome Injection (Marqibo)
January 5, 2018 – 0909 – Atezolizumab (Tecentriq)
January 5, 2018 – 0912 – Ustekinumab (Stelara)
January 5, 2018 – 0913 – Olaratumab (Lartruvo)
January 2, 2018 – 0206 – Parenteral Immunoglobulins
January 2, 2018 – 0264 – Multiple Sclerosis
January 2, 2018 – 0314 – Rituximab (Rituxan)
January 2, 2018 – 0658 – Psoriasis and Psoriatic Arthritis: Targeted Immune Modulators
January 2, 2018 – 0751 – Natalizumab (Tysabri)
January 2, 2018 – 0790 – Golimumab (Simponi and Simponi Aria)
January 2, 2018 – 0905 – Secukinumab (Cosentyx)

Updated:

January 19, 2018 – 0008 – Color-Flow Doppler Echocardiography in Adults
January 19, 2018 – 0365 – Pancreaticoduodenectomy (Whipple Resection)
January 19, 2018 – 0592 – Radiofrequency Ablation of Hypertrophied Nasal Turbinates
January 19, 2018 – 0593 – Aerosolized or Irrigated Anti-infectives for Sinusitis
January 19, 2018 – 0597 – Heart-Lung Transplantation
January 17, 2018 – 0315 – Enbrel (Etanercept)
January 2, 2018 – 0341 – Infliximab
January 2, 2018 – 0595 – Anakinra (Kineret)
January 2, 2018 – 0655 – Adalimumab (Humira)
January 2, 2018 – 0720 – Abatacept (Orencia)
January 2, 2018 – 0761 – Certolizumab Pegol (Cimzia)
January 2, 2018 – 0799 – Tocilizumab (Actemra)
January 2, 2018 – 0839 – Tofacitinib (Xeljanz)

Click here to view the Aetna Medical Policy Updates »

Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!

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Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.

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