Moda Health Plan Medical Policy Updates – September 2022

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

September 2022 Moda Health Plan Medical Policy Updates:

• Anesthesia Physical Status Modifiers (P1 – P6)
• Bendamustine:  Treanda®; Bendeka®; Belrapzo®
• Breyanzi® (lisocabtagene maraleucel)
• Diagnosis Code Requirements – Invalid As Primary
• Diagnosis Code Requirements – Level Of Detail and Number of Characters
• Gender Confirming Surgery
• Ilaris® (canakinumab)
• Ilumya™ (tildrakizumab-asmn)
• Interferential Stimulation Devices (for home use)
• Krystexxa® (pegloticase)
• Kymriah® (tisagenlecleucel)
• Modifier 57 — Decision For Surgery
• Modifiers  XE, XS, XP, XU, and 59 – Distinct Procedural Service
• Orencia® (abatacept)
• Padcev® (enfortumab vedotin-ejfv)
• Patient Lifts (electric or moveable)
• Polivy® (polatuzumab vedotin-piiq)
• Post-operative Sinus Endoscopy and/or Debridement Procedures
• Preventive Services versus Diagnostic and/or Medical Services
• Reduction Mammoplasty
• Spinraza® (nusinersen)
• Technical Component (TC), Professional Component (PC/26), and Global Service Billing
• Vyxeos® (daunorubicin and cytarabine) liposome

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

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