March 2019 Medical Policy Updates:
- Allergy Immunotherapy
- Aprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®)
- Breast Pumps
- Continuous Passive Motion (CPM) Devices in the Home Setting
- Denervation of the Spinal Nerves for Chronic Pain
- Emapalumab-lzsg (Gamifant®)
- Fetal Surgery
- First-Trimester Prenatal Screening for Fetal Aneuploidy Using Fetal Ultrasound Markers
- Hospital Beds and Accessories
- In Vivo Allergy Sensitivity Testing
- Intravenous Chelation Therapy
- Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
- Medical Necessity
- Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
- Neuropsychological Testing for Neurologically Based Conditions
- PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
- Proton Beam Radiation Therapy
- Radiation Therapy Services (Independence)
- Radioimmunotherapy with Ibritumomab Tiuxetan (Zevalin®) (Independence Administrators)
- Radium Ra 223 dichloride (Xofigo®) Injection (Independence Administrators)
- Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers
- Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring
- Tumor Treating Fields
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.