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July 2017 updated medical policies:
Extracorporeal Shock Wave Therapy (ESWT) for Muscoloskeletal Conditions and Soft Tissue Wounds: Lithotripsy, Orthotripsy, OssaTron®, EpoUltra®, SINOCUR®, Orbasone™, Orthospec™ (PDF) Policy 2.01.31 (posted 7/20/17)
Interspinous and Interlaminar Stabilizatio/Distraction Implants (e.g., Coflex®, Interspinous Spacer, Spinal Distraction, Superion®, X STOP) (PDF) Policy 7.01.75 (posted 7/20/17)
Cosmetic and Reconstructive Procedures: Acne Cysts, Actinic Keratoses, Collagen Injection, Complexion Analysis, Dermatoscopy, Drionic, Face Lift, Hairplasty, Hair Transplant, Hyperhydrosis, Iontophoresis, Labiaplasty, Liposuction, Prolaryn, Tattoos, Voice Lift, Benign Skin Lesion Removal, Skin Tag Removal, Keloid Scars, Chemical Peel, Dermabrasion, Port Wine Stains, Rosacea, Vitiligo (PDF) Policy 7.01.11 (posted 7/20/17)4
Fecal Bacteriotherapy, Fecal microbiota therapy (FMT), Fecal transfusion, Fecal transplant, Human probiotic infusion (HPI), Intestinal microbiotia Transplantation (IMT), Microbiome, Stool transplant (PDF) Policy 2.01.48 (posted 7/20/17)
Fecal Incontinence, Radiofrequency Treatment (Secca procedure) (PDF) Policy 7.01.66 (posted 7/20/17)
Surgical Management of Obesity: Adjustable Gastric Band, Bariatric Surgery, Biliopancreatic Diversion, Duodenal Switch, Endobarrier, Gastric Bypass, Gastric Plication, Imbrication, Lap Band, Restorative Obesity Surgery, Ednoluminal [ROSE], Roux-en-Y, Sleeve Gastrectomy, Stomach Stapling, TOGA, Transoral or Vertical Banded Gastroplasty (PDF) Policy 7.01.29 (posted 7/20/17)
Sinus Ostial Dilation for Treatment of Chronic Sinusitis (e.g., Balloon Sinuplasty), catheter sinusotomy (PDF) Policy 7.01.85 (posted 7/20/17)
Phototherapeutic Keratoplasty/Keratectomy, PTK (PDF) Policy 9.01.01 (posted 7/20/17)Artificial Hearts: AbioCor, CardioWest, TAH (PDF) Policy 7.01.65 (posted 7/20/17)
Endovascular Repair (Coil Embolization) of Intracranial Aneurysms – Enterprise Stent, Guglielmi Coil, Neuroform Stent, Pipeline Embolization Device (PEI), Transcatheter Intracranial Embolization (PDF) Policy 7.01.81 (posted 7/20/17)
Ventricular Assist Devices (VAD, LVAD) (PDF) Policy 7.01.07 (posted 7/20/17)
First Trimester Screening for Down Syndrome (e.g., Cell-Free Fetal DNA, Harmony™, Free Beta PAPP-A, MaterniT21™, Non-invasive Prenatal Testing, Nuchal Translucency, Panorama™, Verify®) (PDF) Policy 2.02.25 (posted 7/20/17)
Tumor Chemoresistance and Chemosensitivity Assays: Cytoprint, EDR Assay, Extreme Drug Resistance Assay, Histoculture Drug Response Assay (PDF) Policy 2.02.32 (posted 7/20/17)
Surgical Management of Sleep Disorders/Sleep Apnea: Airvance®, Atrial overdrive pacing, Aura6000 System, CAPSO, Encore™, HGNS®, Hypoglossal Nerve Stimulation, Inspire II Upper Airway Stimulation System, LAUP, Pillar™, Repose™, Snoreplasty, Somnoplasty, UPPP (PDF) Policy 7.01.41 (posted 7/20/17)
Proton Beam Radiation (Charged Particle, Conformal) (PDF) Policy 6.01.11 (posted 7/20/17)
Selective Internal Radiation Therapy (SIRT) for Hepatic Tumors (SIR-Spheres, Theraspheres), Transarterial Raioembolization (TARE) (PDF) Policy 7.01.69 (posted 7/20/17)
Cardiac Computed Tomographic Angiography (Calcium Scoring, Cardiac/Coronary CTA, Coronary Artery CTA, CT Angiography) (PDF) Policy 6.01.34 (posted 7/20/17)
Pancreas Transplant (Pancreas Transplant Alone, Pancreas After Kidney Transplant, Simultaneous Pancreas Kidney Transplant) (PDF) Policy 7.02.01 (posted 7/20/17)
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.