Click here to view the Humana Medical Policy Updates Updates » September 2024 Humana Medical…
Anthem BCBS Medical Policy Updates – January 2019
Click here to view the Anthem Blue Cross Blue Shield Medical Policy Updates »
January 2019 Medical Policy Updates:
- (3D) Three-Dimensional Radiology Services
- Acupuncture When Billed with Evaluation and Management Services- Colorado
- After Hours, Emergency and Misc E^M Services
- Anesthesia Services
- Assistant Surgery Services
- Assistant Surgery Services/Code List
- Bundled Services and Supplies
- Bundled Services and Supplies Code List
- Cancer Treatment Planning and Care Coordination
- CG-DME-40 Electrical Bone Growth Stimulation
- CG-DRUG-16 White Blood Cell Growth Factors
- CG-DRUG-64 FDA-Approved Biosimilar Products
- CG-MED-57 Cardiac Stress Testing with Electrocardiogram (ECG)
- CG-MED-58 Coronary Artery Imaging: Contrast-Enhanced CT Angiography, Fractional Flow Reserve derived from CT, Coronary MRA, and Cardiac MRI
- CG-MED-65 Manipulation Under Anesthesia of the Spine and Joints other than the Knee
- CG-MED-79 Diaphragmatic/Phrenic Nerve Stimulation and Diaphragm Pacing Systems
- CG-MED-80 Positron Emission Tomography (PET) and PET/CT Fusion
- CG-SURG-32 Pain Management: Cervical, Thoracic & Lumbar Facet Injections
- CG-SURG-33 Lumbar Fusion and Lumbar Total Disc Arthroplasty (TDA)
- CG-SURG-38 Lumbar Laminectomy, Hemi-Laminectomy, Laminotomy and/or Discectomy
- CG-SURG-39 Pain Management: Epidural Steroid Injections
- CG-SURG-42 Cervical Fusion
- CG-SURG-43 Knee Arthroscopy
- CG-SURG-44 Coronary Angiography in the Outpatient Setting
- CG-SURG-45 Bone Graft Substitutes
- CG-SURG-47 Surgical Interventions for Scoliosis and Spinal Deformity
- CG-SURG-48 Elective Percutaneous Coronary Interventions (PCI)
- CG-SURG-53 Elective Total Hip Arthroplasty
- CG-SURG-54 Elective Total Knee Arthroplasty
- CG-SURG-55 Intracardiac Electrophysiological Studies (EPS) and Catheter Ablation
- CG-SURG-60 Cervical Total Disc Arthroplasty
- CG-SURG-65 Recombinant Human Bone Morphogenetic Protein
- CG-SURG-67 Treatment of Osteochondral Defects
- CG-SURG-68 Surgical Treatment of Femoroacetabular Impingement Syndrome
- CG-SURG-69 Meniscal Allograft Transplantation of the Knee
- Claim Editing Overview
- Claims Requiring Additional Documentation
- Co-Surgery and Team Surgery
- Documentation ^ Reporting Guidelines for Consultations
- Documentation and Reporting Guidelines for E/M Services
- Documentation Guidelines for Adaptive Behavior Assessments and Treatment for Autism Spectrum Disorder
- Documentation Guidelines for Central Nervous System Assessments and Tests
- Documentation Guidelines for Psychotherapy Services
- Drug Screen Testing
- Duplicate Reporting of Diagnostic Services
- Durable Medical Equipment
- E/M and Related Modifiers 25 and 57
- Expenses Included in Facility Services
- Frequency Editing
- Frequency Editing
- Frequency Editing – Colorado
- Frequency Editing – Nevada
- Global Surgery
- Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation Services
- Health and Behavior Assessment/Intervention Services
- Incident to Services
- Injectable Substances with Related Injection Services � Colorado
- Injectable Substances with Related Injection Services � Nevada
- Injection and Infusion Administration and Related Supplies
- Laboratory and Venipuncture Services
- MED.00100 Diaphragmatic/Phrenic Nerve Stimulation and Diaphragm Pacing Systems
- MED.00110 Growth Factors, Silver-based Products and Autologous Tissues for Wound Treatment and Soft Tissue Grafting
- MED.00123 Axicabtagene ciloleucel (Yescarta®)
- Moderate Sedation � Colorado
- Moderate Sedation � Nevada
- Moderation Sedation Code List � Colorado
- Moderation Sedation Code List � Nevada
- Modifier 22 (Increased Procedural Services)
- Modifier Rules
- Modifiers 59, XE, XP, XS, or XU (Distinct Procedural/ Separate/ Unusual Service)
- Multiple and Bilateral Surgery
- Multiple Diagnostic Cardiovascular Procedures
- Multiple Diagnostic Imaging
- Multiple Diagnostic Ophthalmology Procedures
- Once per Lifetime Procedures
- Overhead Expense For Office Based Surgery and Diagnostic Testing
- Pharmaceutical Waste
- Physical and Manipulative Maintenance Services
- Place of Service
- Prolonged Services
- RAD.00001 Computed Tomography to Detect Coronary Artery Calcification
- RAD.00002 Positron Emission Tomography (PET) and PET/CT Fusion
- RAD.00064 Myocardial Sympathetic Innervation Imaging with or without Single-Photon Emission Computed Tomography (SPECT)
- Routine Obstetric Services
- �Rule of Eight� Reporting Guidelines for Physical Medicine and Rehabilitation Services
- Scope of License
- Screening Services with E/M Services
- Significant Edits � Colorado
- Significant Edits � Nevada
- Sleep Studies and Related Bundled Services and Supplies
- Standby Services
- SURG.00011 Allogeneic, Xenographic, Synthetic and Composite Products for Wound Healing and Soft Tissue Grafting
- SURG.00066 Percutaneous Neurolysis for Chronic Neck and Back Pain
- SURG.00092 Implanted Devices for Spinal Stenosis
- SURG.00114 Facet Joint Allograft Implants for Facet Disease
- SURG.00125 Radiofrequency and Pulsed Radiofrequency Treatment of Trigger Point Pain
- SURG.00127 Sacroiliac Joint Fusion
- SURG.00140 Peripheral Nerve Blocks for Treatment of Neuropathic Pain
- SURG.00142 Genicular Nerve Blocks and Ablation for Chronic Knee Pain
- Surgical Pathology and Related Prostate Needle Biopsy
- Telehealth Services NV
- Telemedicine and Telehealth Services CO
- TRANS.00035 Mesenchymal Stem Cell Therapy For Orthopedic Indications
- Unit Frequency Maximums for Drugs and Biologic Substances
- Urgent Care � Coding and Bundled Supplies
Click here to view the Anthem Blue Cross Blue Shield Medical Policy Updates »
Policy Alerts monitors Commercial and Medicare medical policies for changes. While medical Insurance carriers typically update medical policies annually, there are many reasons why they might review or update a policy. When reviews occur out of cycle they often go unnoticed. Policy Alerts keeps you updated when Payers make coverage changes to medical policies affecting your business.
Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on medical Insurance decisions in real-time. When changes occur, instant email alerts are delivered to your inbox. Clients have access to detailed coverage reports and medical policies through the interactive Policy Alerts Dashboard portal. Save time each month and keep focused on important Payer medical policy reviews and coverage decisions affecting your business!
Policy Alerts takes a client-focused hands-on approach and is constantly working to provide our customers with helpful insights and actionable analytics. We understand what our clients need and are dedicated to providing timely, accurate, and always up-to-date reports.
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. All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or endorsement by them. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.
Related Posts
