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Policy notifications posted as of September 23, 2011

October 3, 2011

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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 September 23, 2011. Policy effective date Notification title Notification issue date September 1, 2011 08.01.03 Belatacept (Nulojix?) September 14, 2011 September 30, 2011 06.02.10g Genetic Testing for Inherited Susceptibility to ColonCancer and Microsatellite Instability Testing (FamilialAdenomatous Polyposis and Lynch Syndrome) August 31, 2011 September 30, 2011 07.07.04b Noncontact Normothermic Wound Therapy August 31, 2011 October 1, 2011 00.03.07 Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products July 1, 2011 October 1, 2011 11.08.20h Wound Care: Bioengineered Skin Substitutes July 1, 2011 October 3, 2011 09.00.46d High Technology Diagnostic Radiology Services September 2, 2011 October 3, 2011 09.00.47 Magnetic Resonance Angiography (MRA) of the Spine September 2, 2011 October 3, 2011 09.00.51 Positron Emission Mammography (PEM) September 2, 2011 October 4, 2011 08.00.44i Zoledronic Acid (Zometa?, Reclast?) July 6, 2011 October 5, 2011 11.08.06f Abdominoplasty and/or Panniculectomy July 7, 2011 October 14, 2011 07.13.05e Photodynamic Therapy (PDT) Using Verteporfin (Visudyne?) September 14, 2011 October 27, 2011 00.10.18g Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS July 29, 2011 November 16, 2011 03.00.32 Modifier 52 Reduced Services August 18, 2011

To view the policy notifications, go to www.amerihealth.com/medpolicy, 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 Materials and Reports 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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