​Effective December 5, 2022, AmeriHealth HMO, Inc. and AmeriHealth Insurance Company of New Jersey (collectively, AmeriHealth New Jersey), AmeriHealth HMO, Inc. (AmeriHealth Pennsylvania), and AmeriHealth Administrators will update their medical policy on ostomy supplies for Commercial members.

The following criteria will be added to this policy as Medically Necessary:

• The individual requires collection or drainage of post-operative related fluids (e.g., anastomotic leak, abscess).

Face-to-face requirement language will be added for the following HCPCS code:

• A5121 Skin barrier; solid, 6x6 or equivalent, each

For more information, view the policy notification, which was published on November 4, 2022.