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Policy notifications posted as of June 22, 2012

June 29, 2012

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 June 22, 2012. Policy effective date Policy No. Notification title Notification issue date June 6, 2012 11.06.09a Labiaplasty May 7, 2012 June 8, 2012 02.01.02a Private Duty Nursing May 9, 2012 July 1, 2012 09.00.32i Diagnostic and Therapeutic Radiopharmaceutical Agents May 30, 2012 July 18, 2012 07.00.01f Biofeedback Therapy June 18, 2012 July 20, 2012 06.02.36 PathfinderTG[]?[] June 20, 2012 July 20, 2012 11.08.05g Application and Removal of Tattoos June 20, 2012 August 8, 2012 11.02.01i Treatment of Varicose Veins of the Lower Extremities and Perforator Vein Incompetence May 10, 2012 August 21, 2012 08.00.68d Ibandronate Sodium (Boniva[]?[]) for Intravenous Injection May 23, 2012 September 1, 2012 00.03.02l Diagnostic Radiology Services Included in Capitation June 1, 2012 September 18, 2012 11.03.01c Repair of Cleft Lip and/or Cleft Palate June 21, 2012 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. [

]NaviNet []?[] is a registered trademark of NaviNet, Inc., an idependent company.[

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