Priority Health January 2018 Medical Policy Updates

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January 2018 Medical Policy Updates:

• Experimental/Investigational/Unproven Care/Benefit Exceptions– 91117 Revised 01/2018
• Genetics: Counseling, Testing and Screening– 91540 Reviewed 11/2017
• Medical Errors: Serious Reportable Events/Hospital-Acquired Conditions– 91516 Reviewed 11/2017
• Orthognathic Surgery– 91273 Revised 11/2017
• Pulse Oximetry for Home Use– 91452 Reviewed 11/2017
• Renal Artery Stenosis– 91561 Reviewed 11/2017
• Speech Therapy– 91336 Reviewed 11/2017
• Sperm and Oocyte Retrieval and Storage– 91393 Reviewed 11/2017
• Thermography– 91355 Reviewed 11/2017
• Transcutaneous Electrical Acustimulation (TEAS) for Hyperemesis– 91576 Reviewed 11/2017
• Autism Spectrum Disorders– 91615 Revised 01/2018
• Computerized Tomographic Angiography Coronary Arteries (CCTA)– 91614 Revised 01/2018
• Hyperhidrosis– 91451 Revised 08/2017
• Infusion Services & Equipment– 91414 Revised 01/2018
• Markers for Digestive Disorders– 91583 Revised 01/2018
• Medical Management of Obesity– 91594 Reviewed 05/2017
• Medical Necessity Determination– 91447 Revised 06/2017
• Menorrhagia Treatment– 91575 Reviewed 08/2017
• Mental Health Residential Treatment: Adult– 91608 Revised 08/2017
• Mental Health Residential Treatment: Child & Adolescent– 91607  Revised 08/2017
• NEW Prostatic Artery Embolization for Benign Prostatic Hyperplasia (BPH)– 91620
• Transurethral Radiofrequency Micro-Remodeling (Renessa) for Female Stress Urinary Incontinence– 91578 Reviewed 11/2017
• Ventricular Assist Devices (VADs) and Artificial Hearts– 91509 Revised 01/2018

Click here to view the Priority Health Medical Policy Updates »

Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!

Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.

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. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.