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Blue Cross Idaho Medical Policy Updates – July 2018
Click here to view the Blue Cross Idaho Medical Policy Updates »
July 2018 Blue Cross Idaho Medical Policy Updates:
- MP 1.01 – Durable Medical Equipment Introduction
- MP 1.01.02 – Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients…
- MP 1.01.06 – Home Apnea Monitoring
- MP 1.01.11 – Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses
- MP 1.01.15 – Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Disorders
- MP 1.01.24 – Interferential Current Stimulation
- MP 1.01.28 – Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis
- MP 1.01.501 – Durable Medical Equipment Guidelines
- MP 1.01.519 – Threshold Electrical Stimulation as a Treatment of Motor Disorders
- MP 1.01.529 – Tumor-Treatment Fields Therapy for Glioblastoma
- MP 1.02.501 – Parenteral, Enteral and Oral Nutrition in the Home
- MP 1.03.05 – Patient-Controlled End of Range Motion Stretching Devices
- MP 1.03.503 – Thoracic-Lumbo-Sacral Orthosis with Pneumatics
- MP 1.04.04 – Myoelectric Prosthesis Components for the Upper Limb
- MP 10.01.10 – Personalized Breast Cancer Screening Clinical Trial
- MP 10.01.500 – COST EFFECTIVE MEDICAL DRUGS
- MP 10.01.501 – Breast Pump Rental
- MP 10.01.510 – Robotic-Assisted Surgery
- MP 2.01.28 – Neurofeedback
- MP 2.01.35 – Paraspinal Surface Electromyography to Evaluate and Monitor Back Pain
- MP 2.01.38 – Transesophageal Endoscopic Therapies for Gastroesophageal Reflux Disease
- MP 2.01.39 – Quantitative Sensory Testing
- MP 2.01.40 – Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions
- MP 2.01.531 – Intra-articular Hyaluronan Injections for Osteoarthritis
- MP 2.01.64 – Biofeedback as a Treatment of Fecal Incontinence or Constipation
- MP 2.01.73 – Actigraphy
- MP 2.01.77 – Automated Point-of-Care Nerve Conduction Tests
- MP 2.01.90 – Navigated Transcranial Magnetic Stimulation
- MP 2.02.01 – Catheter Ablation for Cardiac Arrhythmias
- MP 2.03.07 – Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy
- MP 2.04.07 – Urinary Tumor Markers for Bladder Cancer
- MP 2.04.107 – Carrier Testing for Genetic Diseases
- MP 2.04.110 – Genetic Testing for Mental Health Conditions
- MP 2.04.116 – Invasive Prenatal (Fetal) Diagnostic Testing
- MP 2.04.117 – Genetic Testing of Mitochondrial Disorders
- MP 2.04.119 – Vectra® DA Blood Test for Rheumatoid Arthritis
- MP 2.04.123 – Serum Biomarker Panel Testing for Systemic Lupus Erythematosus
- MP 2.04.127 – Multitarget Polymerase Chain Reaction Testing for Diagnosis of Bacterial Vaginosis
- MP 2.04.131 – Pharmacogenetic Testing for Pain Management
- MP 2.04.140 – Proteogenomic Testing for Patients with Cancer (GPS Cancer test)
- MP 2.04.146 – Gene Expression Profiling for Cutaneous Melanoma
- MP 2.04.38 – Cytochrome p450 Genotyping
- MP 2.04.48 – Genetic Testing for Warfarin Dose
- MP 2.04.502 – Salivary Hormone Testing
- MP 2.04.51 – Genetic Testing for Tamoxifen Treatment
- MP 2.04.52 – PathFinderTG® Molecular Testing
- MP 2.04.69 – Fecal Calprotectin Testing
- MP 2.04.77 – BRAF Gene Mutation Testing To Select Melanoma Patients for BRAF Inhibitor Targeted Therapy
- MP 2.04.78 – Molecular Markers in Fine Needle Aspirates of the Thyroid
- MP 3.01.03 – Quantitative Electroencephalography as a Diagnostic Aid for Attention-Deficit /Hyperactivity Disorder
- MP 3.01.501 – Guidelines for Coverage of Mental and Behavioral Health Services
- MP 3.01.597 – Psychological and Neuropsychological Testing in Young Children with Suspected Autism
- MP 3.02.501 – Methadone Treatment for Opiate Addiction
- MP 3.02.502 – Aversion Therapy for Chemical Dependency
- MP 4.01.04 – Endometrial Ablation
- MP 4.01.11 – Occlusion of Uterine Arteries Using Transcatheter Embolization
- MP 4.01.16 – Progesterone Therapy as a Technique to Reduce Preterm Birth in High-Risk Pregnancies
- MP 4.01.18 – Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome
- MP 4.01.19 – Laparoscopic and Percutaneous Techniques for the Myolysis of Uterine Fibroids
- MP 4.01.21 – Noninvasive Prenatal Testing for Fetal Aneuploidies Using Cell-Free Fetal DNA
- MP 4.02.04 – Reproductive Techniques
- MP 4.02.05 – Preimplantation Genetic Testing
- MP 4.02.510 – Genetic Testing for Recurrent Pregnancy Loss
- MP 5.01.06 – Human Growth Hormone
- MP 5.01.23 – Testosterone Replacement Therapies
- MP 5.01.501 – Guidelines for Prior Authorization of Pharmacologic Therapies
- MP 5.01.505 – Botulinum Toxin
- MP 5.01.515 – Infliximab
- MP 5.01.608 – Pharmacologic Treatment of Hereditary Angioedema
- MP 5.01.609 – Implantable Hormone Pellets
- MP 5.01.611 – Eculizumab (Soliris)
- MP 5.01.612 – Use of Sodium Oxybate (XYREM®)
- MP 6.01.03 – Computed Tomography to Detect Coronary Artery Calcification
- MP 6.01.10 – Stereotactic Radiosurgery and Stereotactic Body Radiotherapy
- MP 6.01.12 – Thermography
- MP 6.01.18 – Scintimammography and Gamma Imaging of the Breast and Axilla
- MP 6.01.20 – Cardiac Applications of Positron Emission Tomography Scanning
- MP 6.01.21 – Magnetoencephalography/Magnetic Source Imaging
- MP 6.01.23 – Diagnosis and Treatment of Sacroiliac Joint Pain
- MP 6.01.25 – Percutaneous Vertebroplasty and Sacroplasty
- MP 6.01.29 – Magnetic Resonance Imaging of the Breast
- MP 6.01.32 – Virtual Colonoscopy/Computed Tomography Colonography
- MP 6.01.33 – Wireless Capsule Endoscopy as a Diagnostic Technique in Disorders of the Small Bowel, Esophagus and Colon
- MP 6.01.37 – Radioimmunoscintigraphy (Monoclonal Antibody Imaging)
- MP 6.01.38 – Percutaneous Balloon Kyphoplasty and Mechanical Vertebral Augmentation
- MP 6.01.40 – Whole Body Dual X-Ray Absorptiometry (DEXA) to Determine Body Composition
- MP 6.01.44 – Vertebral Fracture Assessment with Densitometry
- MP 6.01.45 – Computer-Aided Evaluation of Malignancy with Magnetic Resonance Imaging of the Breast
- MP 6.01.46 – Dynamic Spinal Visualization
- MP 6.01.47 – Functional Magnetic Resonance Imaging
- MP 6.01.48 – Positional Magnetic Resonance Imaging
- MP 6.01.49 – Computed Tomography Perfusion Imaging of the Brain
- MP 6.01.50 – Magnetic Resonance Imaging to Monitor Integrity of Silicone-Gel-Filled Breast Implants
- MP 6.01.51 – Interim PET Scanning in Oncology to Detect Early Response during Treatment
- MP 6.01.52 – Positron Emission Mammography
- MP 6.01.53 – Digital Breast Tomosynthesis
- MP 6.01.54 – Dopamine Transporter Imaging with Single Photon Emission Computed Tomography
- MP 6.01.55 – Beta Amyloid Imaging with Positron Emission Tomography for Alzheimer Disease
- MP 6.01.56 – Myocardial Sympathetic Innervation Imaging in Patients with Heart Failure
- MP 6.01.57 – Radioactive Seed Localization of Nonpalpable Breast Lesions
- MP 6.01.59 – Noninvasive Fractional Flow Reserve Using Computed Tomography Angiography
- MP 7.01.106 – Posterior Tibial Nerve Stimulation
- MP 7.01.107 – Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)
- MP 7.01.125 – Occipital Nerve Stimulation
- MP 7.01.127 – Bronchial Thermoplasty
- MP 7.01.128 – Endobronchial Valves
- MP 7.01.131 – Transcatheter Pulmonary Valve Implantation
- MP 7.01.136 – Radiofrequency Ablation of the Renal Sympathetic Nerves as a Treatment for Resistant Hypertension
- MP 7.01.144 – Patient-Specific Cutting Guides and Custom Knee Implants
- MP 7.01.147 – Ablation Procedures for Peripheral Neuromas
- MP 7.01.148 – Endovascular Therapies for Extracranial Vertebral Artery Disease
- MP 7.01.29 – Percutaneous Electrical Nerve Stimulation and Percutaneous Neuromodulation Therapy
- MP 7.01.541 – Lumbar Spine Fusion
- MP 7.01.71 – Lung Volume Reduction Surgery for Severe Emphysema
- MP 7.01.75 – Cryosurgical Ablation of Primary or Metastatic Liver Tumors
- MP 7.01.86 – Endovascular Stent Grafts for Disorders of the Thoracic Aorta
- MP 7.01.93 – Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation
- MP 7.03 – Transplant Introduction
- MP 7.03.11 – Total Artificial Hearts and Implantable Ventricular Assist Devices
- MP 8.01.01 – Adoptive Immunotherapy
- MP 8.01.13 – Accelerated Breast Irradiation after Breast-Conserving Surgery
- MP 8.01.37 – Inhaled Nitric Oxide
- MP 8.01.40 – Manipulation Under Anesthesia
- MP 8.01.44 – Intradialytic Parenteral Nutrition
- MP 8.01.57 – Baroreflex Stimulation Devices
- MP 8.01.58 – Cranial Electrotherapy Stimulation and Auricular Electrostimulation
- MP 8.01.60 – Extracorporeal Membrane Oxygenation for Adult Conditions
- MP 8.02.04 – Lipid Apheresis
- MP 9.03.21 – Aqueous Shunts and Stents for Glaucoma
- PAP 100 – Contact Information
- PAP 200 – Diagnosis and Procedure Codes
- PAP 202 – Claim Submission Requirements
- PAP 214 – Accidental Injury Questionnaire
- PAP 217 – E Codes
- PAP 218 – Accident and Injury Billing
- PAP 225 – Claim Overpayment and Recoupment
- PAP 232 – Simultaneous Preventive, Evaluation and Management Services
- PAP 234 – Coordination of Benefits (COB)
- PAP 238 – Newborn Metabolic Screening Kit
- PAP 247 – Covered Providers
- PAP 267 – Modifier 22; Increased Procedural Services
- PAP 269 – CPT Modifiers 52 & 53
- PAP 277 – Implantable Device L8699 or Other Unspecified Implantable Devices Billed by ASC
- PAP 288 – Offering Discounts and Coupons
- PAP 357 – Skilled Nursing Facility Coverage Provisions
- PAP 402 – Medicare Crossover Claims
- PAP 504 – Anesthesia Injections
- PAP 505 – Immunization Billing
- PAP293 – CVS Novologix Medical Drug Prior Authorization
Click here to view the Blue Cross Idaho Medical Policy Updates »
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