HCSC Pending Medical Policy Updates – April 2018

Post Views: 1,432

Click here to view the Health Care Service Corporation Pending Medical Policy Updates »

April 2018 Pending Medical Policies:

ADM1001.014 Custodial Care
ADM1001.027 Clinical Trial Treatment or Therapy
DME101.005 Glucose Monitoring and Insulin Delivery Devices for Managing Diabetes
DME101.020 Home Cardiorespiratory Monitoring
DME101.034 Lifts and Elevator Systems
MED201.005 Esophageal pH Monitoring
MED201.013 Prolotherapy
MED201.016 Device Therapies for Gastroesophageal Reflux Disease (GERD)
MED201.029 Transanal Radiofrequency (RF) Treatment of Fecal Incontinence
MED202.018 Plethysmography
MED202.048 Tilt Table Testing
MED205.014 Sensory Stimulation for Coma Patients
MED205.038 Epilepsy Seizure Monitor Alarm System
MED207.092 Cervicography and Speculoscopy
MED207.104 Intravenous Antibiotic Therapy and Associated Diagnostic Testing for Lyme Disease
MED207.115 Biochemical Markers of Alzheimer Disease (AD)
MED207.116 Bone Turnover Markers for Diagnosis and Management of Osteoporosis and Diseases Associated with High Bone Turnover
MED207.118 Fecal Analysis in the Diagnosis of Intestinal Dysbiosis
MED207.128 Salivary Hormone Testing
MED207.133 Measurement of Serum Intermediate Density Lipoproteins (Remnant-Like Particles)
MED207.134 Measurement of Phospholipase A2 in the Assessment of Cardiovascular Risk
MED207.147 Immune Cellular Function Assay to Monitor and Predict Immune Function
MED207.153 Measurement of Serum Antibodies to Infliximab and Adalimumab
MED207.154 Drug Testing In Pain Management and Substance Use Disorder Monitoring
PSY301.019 Biofeedback as a Treatment of Headache
RAD601.014 Thermography
RAD601.042 Wireless Capsule Endoscopy (WCE)
RAD602.011 Ultrasound for the Evaluation of Paranasal Sinuses
RX501.049 Viscosupplementation for Osteoarthritis
RX501.073 Clostridial Collagenase for Fibroproliferative Disorders
RX501.078 Siltuximab (Sylvant)
RX501.084 Eteplirsen (Exondys 51)
RX501.096 Specialty Medication Administration Site of Care
RX502.034 Pertuzumab (Perjeta) for Treatment of HER2-Positive Malignancies
RX502.048 Olaratumab (Lartruvo)
SUR701.018 Cryosurgical Ablation of Miscellaneous Solid Tumors Other Than Liver, Prostate, or Dermatologic Tumors
SUR701.019 Image Guidance Surgery (IGS) System
SUR701.027 Intracranial Stenting or Angioplasty, including Endovascular Procedures
SUR701.030 Radiofrequency Ablation of the Renal Sympathetic Nerves as a Treatment for Resistant Hypertension
SUR701.038 Microwave Tumor Ablation
SUR702.016 Intravenous Anesthetics for the Treatment of Chronic Pain
SUR703.001 Organ and Tissue Transplantation (General Donor and Recipient Information)
SUR703.002 Hematopoietic Stem-Cell (HSC) Transplantation (HSCT) or Additional Infusion Following Preparative Regimens (General Donor and Recipient Information)
SUR703.029 Hematopoietic Stem-Cell Transplantation for Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL)
SUR703.030 Hematopoietic Stem-Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma (MM) and POEMS Syndrome
SUR703.031 Hematopoietic Stem-Cell Transplantation for Non-Hodgkin Lymphomas
SUR703.037 Hematopoietic Stem-Cell Transplantation for Acute Myelogenous Leukemia (AML)
SUR703.046 Hematopoietic Stem-Cell Transplantation for Primary Systemic Amyloidosis
SUR703.049 Fecal Microbiota Transplantation (FMT)
SUR704.008 Laser Treatment of Congenital Port Wine Stain (PWS), Hemangiomas, and Other External Vascular Malformations
SUR705.011 Distraction Devices, External Fixation Devices and Bone Lengthening Devices
SUR706.009 Sleep Related Breathing Disorders: Surgical Management
SUR707.020 Minimally Invasive Coronary Artery Bypass Graft Surgery
SUR710.021 Radiofrequency Energy Therapy for Stress Urinary Incontinence (SUI)
SUR712.009 Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation
SUR712.030 Direct Brain Infusion – Convection-Enhanced Delivery of Therapeutic Agents
THE801.026 Extracorporeal Photopheresis (ECP)
THE801.027 Dermatologic Applications of Photodynamic Therapy (PDT)
THE801.035 Insulin Potentiation Therapy
THE803.009 Gait Analysis
THE803.014 Speech Therapy

Click here to view the Health Care Service Corporation Pending 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!

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.

Health Care Service Corporation (HCSC)