All policies are posted prior to their effective date. Below is a listing of
the policy notifications that we have posted to our website as of February 28,
2013.
Policy effective date
Pol No.
Notification title
Notification issue date
February 25, 2013
07.08.03
Medical and Surgical Treatment of Temporomandibular Joint Disorder
November 27, 2012
March 5, 2013
11.14.26
Surgical Treatments of Athletic Pubalgia
December 5, 2012
March 29, 2013
08.01.05
Carfilzomib (Kyprolis? )
February 27, 2013
March 29, 2013
08.01.09
Omacetaxine mepesuccinate (Synribo
?)
February 27, 2013
April 1, 2013
05.00.58f
Home Oxygen Therapy
February 28, 2013
April 2, 2013
11.14.08c
Orthognathic Surgery
January 2, 2013
April 2, 2013
08.00.81b
Bendamustine Hydrochloride (Treanda
?)
January 2, 2013
April 2, 2013
11.14.03e
Meniscal Allograft Transplantation
January 2, 2013
April 4, 2013
08.00.25g
Treatment of Pulmonary Artery Hypertension with Intravenous, Subcutaneous, and
Inhaled Pharmacologic Agents Intended for Home Use
January 4, 2013
April 16, 2013
07.02.07g
Ambulatory, Real-Time Cardiac Surveillance System
January 16, 2013
April 16, 2013
11.05.02g
Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and
Canthoplasty/Canthopexy
January 16, 2013
April 17, 2013
11.15.09d
Denervation of the Spinal Nerves for Chronic Facet Pain
January 17, 2013
To view the policy notifications, visit our
Medical Policy website,
select Accept and Go to Medical Policy Online, and click on the
Policy Notifications box. You can also view policy notifications using the
NaviNet® web portal by selecting Reference Tools from the
Plan Transactions menu, then Medical Policy. Once these policies are in
effect, they will be available by using the Search box on the Medical Policy
homepage. Be sure to check back often, as the site is updated frequently.