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 March 26, 2012.
Policy effective date
Policy no.
Notification title
Notification issue date
March 20, 2012
11.08.03h
Lipectomy and Liposuction
December 21, 2011
March 21, 2012
10.01.01i
Cardiac Rehabilitation and Intensive Cardiac Rehabilitation Programs
January 18, 2012
March 30, 2012
07.00.14d
Cold Laser Therapy
February 29, 2012
March 30, 2012
07.03.05l
Sleep Disorder Testing
February 29, 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
April 5, 2012
07.03.20
Surface Electromyelogram
March 6, 2012
June 1, 2012
09.00.46f
High-Technology Diagnostic Radiology Services
March 2, 2012
To view the policy notifications, go to 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.
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