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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
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