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Upcoming precertification changes for outpatient, non-emergent radiation therapy services

October 3, 2016

Independence currently requires precertification through CareCore National, LLC d/b/a eviCore healthcare (eviCore), an independent company, for outpatient, non-emergent radiation therapy services for commercial and Medicare Advantage members.

Effective January 1, 2017, the following procedure codes will require precertification:

  • C2616: Brachytherapy source, non-stranded, yttrium-90, per source
  • Q3001: Radioelements for brachytherapy, any type, each

The following medical policies were updated to reflect the addition of the above procedure codes and were posted as Notifications on September 30, 2016, and will become effective on January 1, 2017:

  • Commercial: #09.00.56c: Radiation Therapy Services
  • Medicare Advantage: #MA09.020c: Radiation Therapy Services

To view the Notifications for these policies, visit our Medical Policy Portal and select Accept and Go to Medical Policy Online. Then select either Commercial or Medicare Advantage under Active Notifications.

If you have any questions, please contact your Network Coordinator.


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