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Policy notifications posted as of January 20, 2012

January 31, 2012

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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 January 20, 2012.

Policy effective date

Policy No.

Notification title

Notification issue date

January 18, 2012

11.14.02i

Trigger Point Injections

December 19, 2011

January 20, 2012

00.01.18b

Reimbursement for Associated Services Performed in Conjunction with Dental Services

December 21, 2011

January 20, 2012

08.01.02

Pegloticase (Krystexxa)

January 10, 2012

January 20, 2012

12.00.03a

Alternative Therapies and Complementary Medicine

December 21, 2011

January 20, 2012

08.00.75d

Erythropoiesis Stimulating Agents (ESAs)

December 21, 2011

January 20, 2012

00.10.21b

Collection and Interpretation of Physiologic Data

December 21, 2011

January 24, 2012

08.00.62d

Abatacept (Orencia®) for injection for intravenous use

October 26, 2011

January 24, 2012

11.08.15m

Reconstructive Breast Surgery

October 26, 2011

February 3, 2012

11.00.13d

Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

January 4, 2012

February 3, 2012

11.08.02e

Reduction Mammoplasty

January 4, 2012

February 3, 2012

11.07.02f

Sentinel Node Biopsy

January 4, 2012

February 3, 2012

05.00.60d

Pressure Reducing Support Surfaces

January 4, 2012

February 16, 2012

06.02.09e

Human Immunodeficiency Virus (HIV) Genotyping and Phenotyping

January 17, 2012

February 16, 2012

05.00.30f

Noninvasive Respiratory Assist Devices (RADs): Continuous Positive Airway Pressure (CPAP) Devices and Bi-Level Devices

January 17, 2012

February 17, 2012

11.08.19j

Prophylactic Mastectomy

January 18, 2012

March 7, 2012

08.09.11n

Medicare Part B vs. Part D Crossover Drugs

January 6, 2012

March 20, 2012

11.08.03h

Lipectomy and Liposuction

December 21, 2011

March 21, 2012

10.01.01i

Cardiac Rehabilitation and Intensive Cardiac Rehabilitation

January 18, 2012

April 4, 2012

11.17.06h

Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)

January 5, 2012

April 4, 2012

10.06.01e

Speech Therapy

January 5, 2012

April 4, 2012

07.13.07e

Corneal Pachymetry Using Ultrasound

January 5, 2012

April 4, 2012

10.04.01j

Pulmonary Rehabilitation

January 5, 2012

April 4, 2012

11.08.12g

Surgery for Gynecomastia

January 5, 2012

April 4, 2012

05.00.09e

Bone Growth Stimulators

January 5, 2012

April 4, 2012

05.00.37d

Compression Garments

January 5, 2012

April 5, 2012

07.03.09h

Electromyography (EMG) Studies: Needle EMG, Surface EMG (SEMG)

January 6, 2012

April 5, 2012

07.03.18g

Nerve Conduction Studies (NCS) and Related Electrodiagnostic Studies

January 6, 2012

Visit the Medical Policy Portal located on our IBC website for the latest policy notifications.

Select Accept and Go to Medical Policy Online, agree to the Terms and Conditions, then select the Policy Notifications section located on the middle of the screen.

You can also read policy notifications using the NaviNet® web portal. Log onto NaviNet, select 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 portal.

Be sure to check back often, as the site is updated frequently.

NaviNet® is a registered trademark of NaviNet, Inc., an independent company.

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