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 October 27,
2011.
Policy effective date
Notification title
Notification
issue date
October 26, 2011
11.08.14f Removal of breast implants
September 26, 2011
October 27, 2011
00.10.18g Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS
July 29, 2011
October 28, 2011
07.00.21d Allergy Immunotherapy
September 28, 2011
October 28, 2011
11.02.17c Endovascular Stent-Graft Repair of the Thoracic Aneurysm and
Dissection
September 28, 2011
October 28, 2011
06.02.01d Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Treatment
September 28, 2011
October 28, 2011
12.04.02b Nonemergency Ambulance Transport Services
September 28, 2011
November 9, 2011
05.00.21h Durable Medical Equipment (DME)
October 10, 2011
November 9, 2011
05.00.42d Patient Lifts
October 10, 2011
November 9, 2011
05.00.71 Standing Frames
October 10, 2011
November 11, 2011
10.00.02a Day Rehabilitation
October 12, 2011
November 11, 2011
07.05.07 Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic
Malignancies
October 12, 2011
November 11, 2011
07.03.03d Medical Evaluation and Management for Attention-Deficit Hyperactivity
Disorder (ADHD)
October 12, 2011
November 16, 2011
03.00.32 Modifier 52 Reduced Services
August 18, 2011
January 1, 2012
07.03.14e Inoperative Neurophysiological Monitoring (INM)
October 3, 2011
January 10, 2012
05.00.56e Hospital Beds and Accessories
October 14, 2011
January 11, 2012
08.01.04 Preventive Immunization
October 13, 2011
January 24, 2012
08.00.62d Abatacept (Orencia
?) for injection for intravenous use
October 26, 2011
January 24, 2012
11.08.15m Reconstructive Breast Surgery
October 26, 2011
To view the policy notifications, go to www.ibx.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.