Aetna Medical Policy Updates – April 2018

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April 2018 Medical Policy Updates:

New:

April 3, 2018 – 0928 – Optical Coherence Tomography of the Middle Ear

Revised:

April 12, 2018 – 0174 – Pool Therapy, Aquatic Therapy or Hydrotherapy
April 12, 2018 – 0177 – Helicobacter Pylori Infection Testing
April 12, 2018 – 0181 – Evoked Potential Studies
April 12, 2018 – 0184 – Pulmonary Hypertension Treatments and Selected Indications of Prostanoids
April 12, 2018 – 0191 – Vagus Nerve Stimulation
April 12, 2018 – 0194 – Spinal Cord Stimulation
April 12, 2018 – 0202 – Magnetic Resonance Spectroscopy (MRS)
April 12, 2018 – 0205 – Phototherapy and Photochemotherapy (PUVA) for Skin Conditions
April 12, 2018 – 0314 – Rituximab (Rituxan)
April 12, 2018 – 0606 – Hematopoietic Cell Transplantation for Autoimmune Diseases and Miscellaneous Indications
April 12, 2018 – 0804 – Denosumab (Prolia and Xgeva)
April 11, 2018 – 0153 – Thalamotomy
April 11, 2018 – 0155 – Ribavirin (Virazole)
April 11, 2018 – 0157 – Obesity Surgery
April 11, 2018 – 0158 – Neuropsychological and Psychological Testing
April 11, 2018 – 0161 – Infusion Pumps
April 11, 2018 – 0165 – Cardiac Catheter Ablation and Radioablation
April 11, 2018 – 0166 – Fetal Fibronectin, Inflammatory Biomarkers, and Salivary Estriol Testing for Preterm Labor
April 11, 2018 – 0168 – Tumor Scintigraphy
April 11, 2018 – 0170 – Growth Hormone (GH) and Growth Hormone Antagonists
April 11, 2018 – 0171 – Magnetic Resonance Imaging (MRI) of the Extremities
April 11, 2018 – 0172 – Hyperbaric Oxygen Therapy (HBOT)
April 4, 2018 – 0839 – Tofacitinib (Xeljanz)
April 4, 2018 – 0858 – Organ Prolapse: Selected Procedures
April 3, 2018 – 0132 – Biofeedback
April 3, 2018 – 0134 – Bone Mass Measurements
April 3, 2018 – 0135 – Acupuncture
April 3, 2018 – 0643 – Diagnosis of Vaginitis
April 3, 2018 – 0650 – Polymerase Chain Reaction Testing: Selected Indications
April 3, 2018 – 0658 – Psoriasis and Psoriatic Arthritis: Targeted Immune Modulators
April 3, 2018 – 0784 – Blood and Adipose Product Injections for Selected Indications
March 30, 2018 – 0009 – Orthopedic Casts, Braces and Splints
March 30, 2018 – 0067 – Chest Physiotherapy and Airway Clearance Devices
March 30, 2018 – 0069 – Lymphedema
March 30, 2018 – 0071 – Positron Emission Tomography (PET)
March 30, 2018 – 0079 – Benign Prostatic Hypertrophy (BPH)
March 30, 2018 – 0088 – Antepartum Fetal Surveillance
March 30, 2018 – 0091 – Endometrial Ablation
March 30, 2018 – 0095 – Orthognathic Surgery
March 30, 2018 – 0100 – Cryoablation
March 30, 2018 – 0105 – Magnetic Resonance Imaging (MRI) of the Breast
March 30, 2018 – 0111 – Indocyanine Green Angiography
March 30, 2018 – 0113 – Botulinum Toxin
March 29, 2018 – 0327 – Infertility
March 29, 2018 – 0473 – Vaccines for Travel
March 29, 2018 – 0577 – Laser Treatment for Psoriasis and Other Selected Skin Conditions
March 29, 2018 – 0598 – Lung Transplantation
March 28, 2018 – 0142 – Breast Implant Removal
March 28, 2018 – 0147 – Complex Regional Pain Syndrome (CRPS)/Reflex Sympathetic Dystrophy (RSD): Diagnosis
March 28, 2018 – 0227 – BRCA Testing, Prophylactic Mastectomy, and Prophylactic Oophorectomy
March 28, 2018 – 0244 – Wound Care
March 28, 2018 – 0715 – Pharmacogenetic and Pharmacodynamic Testing

Updated:

None

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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!

Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.

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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