HealthPartners Medical Policy Updates – June 2018

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June 2018 Medical Policy Updates

• Advanced drug therapy for pulmonary hypertension: epoprostenol (generic, Flolan® and Veletri®), treprostinil (Remodulin® & Tyvaso®), iloprost (Ventavis®) and sildenafil injection (Revatio®)
• Alemtuzumab (Lemtrada™)
• Buprenorphine injectable (Sublocade)
• Category III CPT codes
• Children’s residential treatment services – Minnesota Health Care Programs
• Compounded medications
• Cranial remolding helmet/band and protective helmet
• Dental Services – Ambulatory Hospitalization and Anesthesia for Dental Care – North Dakota
• Dental Services – Cone beam computed tomography (CBCT) scan for medically-related dental services
• Dental Services- Ambulatory Hospitalization and Anesthesia for Dental Care
• Diabetic monitors / meters
• DME Benefits Grid
• Eculizumab (Soliris®)
• Eteplirsen (Exondys 51™)
• Gender reassignment surgery
• Gender-Confirming Surgery – Minnesota Health Care Programs
• Growth deficiency therapy
• Growth hormone drugs – Wisconsin
• Hospital Bed
• Hospital Bed – Minnesota Health Care Programs
• In Vitro Fertilization (IVF) and other Advanced Assisted Reproductive Technology (ART)
• Infliximab (Remicade®, Inflectra®, Renflexis®)
• Infliximab (Remicade®, Inflectra®, Renflexis®) – Minnesota Health Care Programs
• In-Network benefit requests – Effective 4/1/2018
• Investigational services – list of non-covered services
• Lift Chair Mechanism
• Lift Chair Mechanism-Minnesota Health Care Programs
• Neuropsychological testing
• Nusinersen (Spinraza)
• Oral appliances for sleep disorders – Minnesota Health Care Programs
• Plerixafor (Mozobil®)
• Pneumatic compression devices and heat/cold therapy units – Minnesota Health Care Programs
• Recent Food and Drug Administration (FDA) approved medications coverage policy
• Varicose vein procedures – Retire 7/31/2018

Click here to view the HealthPartners 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.

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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.