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 July 31, 2013.
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April 4, 2013
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11.03.11h
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Procedures for the Treatment of Gastroesophageal Reflux
Disease (GERD)
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July 15, 2013
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July 24, 2013
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05.00.72b
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Upper Limb Prostheses
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June 24, 2013
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July 24, 2013
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11.14.21c
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Microprocessor-Controlled Prostheses for
Lower-Extremity Amputees
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June 24, 2013
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July 31, 2013
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00.01.25s
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PPO Network Rules for Provision of Specialty Services for
Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and
Rehabilitative Services
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July 1, 2013
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July 31, 2013
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00.03.07f
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Laboratory Services for Members Enrolled in
Health
Maintenance Organization (HMO) or Health Maintenance Organization
Point-of-Service (HMO-POS) Products
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July 1, 2013
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August 2, 2013
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11.01.04c
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Auditory Brainstem Implant
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July 3, 2013
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August 2, 2013
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11.15.03g
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Insertion of Implantable Infusion Pumps
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July 3, 2013
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August 6, 2013
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11.14.07j
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Intra-articular Injection of Hyaluronan for the Treatment of
Osteoarthritis
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May 8, 2013
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August 14, 2013
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05.00.01h
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Pneumatic Compression Therapy Devices for Lymphedema and
Chronic Venous Insufficiency
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July 15, 2013
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August 14, 2013
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07.02.09b
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Ambulatory Blood Pressure Monitoring (ABPM)
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July 15, 2013
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August 14, 2013
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11.08.15o
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Reconstructive Breast Surgery
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July 15, 2013
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August 14, 2013
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11.15.01j
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Spinal Cord Stimulation (Dorsal Column Stimulation)
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July 15, 2013
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September 1, 2013
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07.03.05o
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Sleep Disorder Testing
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June 3, 2013
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October 1, 2013
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05.00.38f
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Negative-Pressure Wound Therapy (NPWT) Systems
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July 3, 2013
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October 1, 2013
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07.03.14i
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Intraoperative Neurophysiological Monitoring (INM)
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July 3, 2013
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To view the policy
notifications, visit our Medical
Policy portal, 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.
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Inc.