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Blue Cross and Blue Shield of North Carolina Medical Policy Update for October 27 2017:
|Reason for Update
|Added “Maximum Units of Service” to list of Related Policies. Minor revision to When Covered section; removed the following statement from paragraph below item 4b – “Additional testing beyond this number will require individual review for medical necessity.” No change to policy intent.
|Code Bundling Rules Not Addressed in Claim Check
|The following information is added to the section on Status “B” codes: Status B code edits are applied to professional and outpatient facility claims. Notification given 8/25/17 for policy effective date of 10/27/17.
|Endovascular Procedures for Intracranial Arterial Disease
|Focal Treatments for Prostate Cancer
|Reference added. Minor revisions to Description of Procedure.
|Infertility, Diagnosis and Treatment
|Added codes 89290 and 89291 to Billing/Coding section. Specialty Matched Consultant Advisory Panel review 9/27/2017. No change to policy statement.
|Intrauterine Ablation or Resection of the Endometrium
|Added “congenital uterine anomaly” to list of medical contraindications. Reference added. Specialty Matched Consultant Advisory Panel review 9/27/2017. No change to policy statement.
|Maximum Units of Service
|The following statement added to Guidelines section: For allergy testing, greater than 42 patch tests will be reviewed by individual consideration. Documentation of medical necessity for over 42 tests will be necessary. Specific IgE in vitro testing is limited to 36 allergen specific antibodies. Refer to separate medical policy titled “Allergy Testing.” The following statement added to Billing/Coding section: Editing for maximum units of service is not limited to the specific codes listed in this policy.
|Myoelectric Prosthetic Components for the Upper Limb
|Noninvasive Fetal RHD Genotyping Using Cell Free Fetal DNA
|Policy Guidelines updated. Reference added. Specialty Matched Consultant Advisory Panel review 9/27/2017. No change to policy statement.
|Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors
|Reference added. Microwave Tumor Ablation added to Related Policies list. Codes 47380 and 47382 removed from Billing section as they pertain to liver tumors.
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