Moda Health Medical Policy Updates – August 2018

Click here to view the Moda Health Plan Medical Policy Updates »

August 2018 Moda Health Plan Medical Policy Updates:

• Abdominoplasty/Panniculectomy
• Add-on Codes
• Air Ambulance Transport
• Aliqopa™ (copanlisib)
• Anesthesia for Routine Gastrointestinal Endoscopic Procedures
• Applied Behavior Analysis
• Behavioral Health Case Management & Care Coordination
• Berinert® (C1 Esterase Inhibitor, Human)
• Botox® (onabotulinumtoxinA)
• Chemical Dependency Inpatient, Residential, and Outpatient Treatment
• Clinical Drug Screening and/or Drug Testing
• Cochlear Implants and Auditory Brainstem Implants
• Computer Assisted Navigation for Musculoskeletal Procedures
• Continuous Glucose Monitoring (CGM)
• Cranial Orthotics
• Drugs and Biologicals, Wastage and/or Discarded Amounts (Modifier JW)
• Dysport™ (abobotulinumtoxinA)
• Eating Disorders
• Hospital Routine Supplies and Services
• Inpatient Mental Health
• Kalbitor® (ecallantide)
• Long-Term Psychotherapy
• Medical Records Documentation Standards
• Medical, Surgical, and Routine Supplies (including but not limited to 99070)
• Mental Health Outpatient Treatment for Adjustment Disorder
• Mental Health Outpatient Treatment for Dissociative Disorders
• Mental Health Outpatient Treatment for Reactive Attachment Disorder
• Mental Health Partial Hospitalization and Intensive Outpatient Treatment
• Mental Health Residential – Children, Adolescents and Adults
• Moderate (Conscious) Sedation
• Modifier SL – State Supplied Vaccine
• Modifiers 80, 81, 82, and AS – Assistant At Surgery
• Myobloc® (rimabotulinumtoxinB)
• Nutrition Therapy for Eating Disorder
• Operating Microscope (CPT Code 69990)
• Orencia® (abatacept)
• Procedure Codes Assigned to Surgical Benefit Categories
• Procedures and Services Considered Always Investigational or Cosmetic
• Radiology Reductions for Technology Type – Modifiers FX & XY
• Reduction Mammoplasty
• Remicade® (infliximab)
• Renflexis (infliximab-abda)
• Routine Venipuncture and/or Collection of Specimens
• Simponi ARIA® (golimumab)
• Sinus Surgery
• Spinal Cord Stimulators
• Stelara® (ustekinumab)
• Transcranial Magnetic Stimulation
• Urinary Incontinence Treatment
• Valid Modifier to Procedure Code Combinations
• Xeomin® (incobotulinumtoxinA)

Click here to view the Moda Health Plan Medical Policy Updates »

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