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Paramount Healthcare September 2017 Medical Policy Updates

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Updates for September 2017

POLICY

 

STATUS

 

REVISION

 

PG0308 Pulsed Dye Laser Therapy for Cutaneous Vascular Lesions Revision
PENDING
Effective 12/29/17
09/22/17: Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0281 Cochlear and Auditory Brainstem Implants Revision
PENDING
Effective 12/29/17
09/22/17: Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0339 Gait Analysis Revision
PENDING
Effective 12/29/17
09/22/17: Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0407 Frenectomy or Frenotomy for Ankyloglossia New
PENDING
Effective 12/29/17
09/22/17: Policy created to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0410 Deep Brain, Cortical, and Cerebellar Stimulation New
PENDING
Effective 12/29/17
09/22/17: Policy created to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0409 Ketamine for Treatment of Psychiatric Disorders and Pain Management New
PENDING
Effective 12/29/17
09/22/17: Policy created to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0411 Genetic Testing for Duchenne and Becker Muscular Dystrophy New
PENDING
Effective 12/29/17
09/22/17: Policy created to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0327 Glaucoma Treatment with Aqueous Drainage Device Revision
PENDING
Effective 12/29/17
09/22/17: Added effective 07/01/2017 new code 0474T as covered without prior authorization for HMO, PPO, Individual Marketplace, & Elite per CMS guidelines. Procedure 0474T is non-covered per ODM guidelines. Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0043 New Experimental Services Revision
PENDING
Effective 12/29/17
09/22/17: Added new codes 0469T-0473T, 0475T-0478T effective 7-1-17 as non-covered for all product lines. PG0327 Glaucoma Treatment with Aqueous Drainage Device effective 7-1-17 added new code 0474T. Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0412 Genetic Testing for Macular Degeneration New
PENDING
Effective 12/29/17
09/22/17: Policy created to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0413 Peristeen Anal Irrigation System New
PENDING
Effective 12/29/17
09/22/17: Policy created to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0358 Genetic Counseling  Revision
PENDING
Effective 12/29/17
09/22/17: Coverage of genetic counseling changed from three (3) visits to two (2) visits. Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).

 

 

 

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