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 July 20, 2011.
Policy effective date Notification title Notification issue date July 22, 2011 08.00.99 Belimumab (Benlysta?) June 22, 2011 July 22, 2011 05.00.55g Wheelchair Cushions and Seating June 22, 2011 July 27, 2011 05.00.70 Mechanical Stretching Devices for the Treatment of Joint Stiffness or Contractures April 28, 2011 July 27, 2011 05.00.15k Nebulizers June 27, 2011 August 5, 2011 08.01.01 Ipilimumab (Yervoy?) July 6, 2011 August 5, 2011 11.14.10i Percutaneous Vertebroplasty, Kyphoplasty, and Sacroplasty July 6, 2011 August 19, 2011 08.00.92b Coagulation Factors for Hemophilia July 20, 2011 August 19, 2011 07.00.03i Full-Body Monoplace or Multiplace Chamber Hyperbaric Oxygen Therapy July 20, 2011 August 19, 2011 08.01.00 Hydroxyprogesterone Caproate Injection as a Technique to Reduce the Rink of Preterm Birth in High-Risk Pregnancies July 20, 2011 August 19, 2011 11.15.23 Transforaminal Epidural Nerve Block Injections July 20, 2011 August 24, 2011 09.00.36f First-Trimester Prenatal Screening for Fetal Aneuploidy May 26, 2011 August 31, 2011 11.01.06 Bone-Anchored (Osseointegrated) Hearing Aids, Implantable Bone-Conduction Hearing Aids, and Semi-Implantable Hearing Aids June 1, 2011 September 1, 2011 00.01.52 Always Bundled Procedure Codes June 3, 2011 September 1, 2011 11.05.02f Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and Canthoplasty/Canthopexy June 3, 2011 September 1, 2011 10.02.02e Chiropractic Spinal and Extraspinal Manipulation Therapy June 1, 2011 September 1, 2011 10.03.01b Physical Medicine and Rehabilitation Services June 1, 2011 September 1, 2011 11.02.01h Treatment of Varicose Veins of the Lower Extremities and Perforator Vein Incompetence June 8, 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 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

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.