Medical Policy and Coding Updates June 2020

  • Updates for both non-individual and individual plans

  • Effective September 4, 2020

    Folate Antimetabolites, 5.01.617
    This is a new policy. The following drugs have been added and may be considered medically necessary when criteria are met:

    Alimta® (pemetrexed)

    • In combination with Keytruda® (pembrolizumab) and platinum chemotherapy for the initial treatment of metastatic non-squamous non-small cell lung cancer (NSCLC)
    • In combination with cisplatin for the initial treatment of locally advanced or metastatic, non-squamous NSCLC
    • As a single agent for the maintenance treatment of locally advanced or metastatic, non-squamous NSCLC in patients whose disease has not progressed after four cycles of platinum-based first-line chemotherapy
    • As a single agent for the treatment of recurrent, metastatic non-squamous, NSCLC after prior chemotherapy
    • Initial treatment, in combination with cisplatin, of malignant pleural mesothelioma in patients whose disease can’t be surgically treated or who are not candidates for curative surgery

    Folotyn® (pralatrexate)

    • Treatment of relapsed or refractory peripheral T-cell lymphoma (PTCL)

    Pharmacologic Treatment of Gout, 5.01.616
    This is a new policy. The following drug has been added and may be considered medically necessary when criteria are met:

    Krystexxa® (pegloticase)

    • Treatment of chronic gout in patients age 18 and older

    Effective August 16, 2020

    Updates to AIM Specialty Health® Clinical Appropriateness Guidelines

    Effective for dates of service on and after August 16, 2020, the following updates by will apply to the AIM Specialty Health® Clinical Appropriateness Guidelines for Radiology: Chest Imaging

    Updates by section:

    Tumor or Neoplasm

    • Allowed follow up of nodules less than 6 mm in size seen on incomplete thoracic CT, in alignment with follow up recommendations for nodules of the same size seen on complete thoracic CT
    • Added new criteria for which follow up is indicated for mediastinal and hilar lymphadenopathy
    • Separated mediastinal/hilar mass from lymphadenopathy, which now has its own entry

    Parenchymal Lung Disease – not otherwise specified

    • Removed as it is covered elsewhere in the document (parenchymal disease in “Occupational lung diseases” and pleural disease in “Other thoracic mass lesions”)

    Interstitial lung disease (ILD), non-occupational, including idiopathic pulmonary fibrosis (IPF)

    • Defined criteria warranting advanced imaging for both diagnosis and management

    Occupational lung disease (Adult only)

    • Moved parenchymal component of asbestosis into this indication
    • Added Berylliosis

    Chest Wall and Diaphragmatic Conditions

    • Removed screening indication for implant rupture due to lack of evidence indicating that outcomes are improved
    • Limited evaluation of clinically suspected rupture to patients with silicone implants

    Effective for dates of service on and after August 16, 2020, the following updates by will apply to the AIM Specialty Health® Clinical Appropriateness Guidelines for Radiology: Oncology Imaging

    Updates by section:

    MRI breast

    • New indication for BIA-ALCL
    • New indication for pathologic nipple discharge
    • Further define the population of patients most likely to benefit from preoperative MRI

    Breast cancer screening

    • Added new high risk genetic mutations appropriate for annual breast MRI screening

    Lung cancer screening

    • Added asbestos-related lung disease as a risk factor

    Effective for dates of service on and after August 16, 2020, the following updates by will apply to the AIM Specialty Health® Clinical Appropriateness Guidelines for Sleep Disorder Management

    Updates by section:

    Bi-Level Positive Airway Pressure Devices

    • Change in BPAP FiO2 from 45 to 52 mmHg based on strong evidence and aligns with Medicare requirements for use of BPAP

    Multiple Sleep Latency Testing and/or Maintenance of Wakefulness Testing

    • Style change for clarity

    Effective August 7, 2020

    IL-5 Inhibitors, 5.01.559
    The following drug has been added and may be considered medically necessary when criteria are met:

    Cinqair® (reslizumab)

    • As an add-on maintenance treatment of severe asthma for patients ages 18 and older

    Re-authorization criteria have been added

    • A decrease in requirement for oral steroids, exacerbation frequency, ER and urgent care visits, and hospitalizations; or a decrease in the frequency and severity of asthma symptoms; or an increase in quality of life measures and ability to perform activities of daily living

    Effective July 2, 2020

    Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions, 7.01.569

    Removed from policy

    • Site of service criteria and reference to policy, Site of Service: Select Surgery Procedures – 11.01.524, have been removed
    • Site of service will be included in the medical necessity review for the primary procedure (knee arthroplasty, knee arthroscopy) using InterQual® criteria

    Electrostimulation and Electromagnetic Therapy for Treating Wounds, 2.01.57

    Policy Reinstated

    • This policy was previously archived in 2018 and is being reinstated
    • Electrical stimulation and electromagnetic therapy for the treatment of wounds is considered investigational

    Erythroid Maturation Agents, 5.01.614
    The following drug has been added and may be considered medically necessary when criteria are met:

    Reblozyl® (luspatercept-aamt)

    • Treatment of anemia in adults ages 18 and older with beta thalassemia

    Meniscal Allografts and Other Meniscal Implants, 7.01.15

    Removed from policy

    • Site of service criteria and reference to policy, Site of Service: Select Surgery Procedures – 11.01.524, have been removed
    • Site of service will be included within the medical necessity review for a knee arthroscopy procedure using InterQual® criteria

    Miscellaneous Oncology Drugs, 5.01.540
    The following drug has been added and may be considered medically necessary when criteria are met:

    Padcev™ (enfortumab vedotin-ejfv)

    • Treatment of locally advanced or metastatic urothelial cancer (mUC) in patients ages 18 and older

    Effective June 5, 2020

    Miscellaneous Oncology Drugs, 5.01.540
    The following drug has been added and may be considered medically necessary when criteria are met:

    Darzalex® (daratumumab)

    • Treatment of multiple myeloma in adults when used as a combination treatment or monotherapy

    New medical policies

    Effective May 27, 2020

    SARS-CoV-2 Serology (Antibody) Testing, 2.04.518
    This is a new policy. SARS-CoV-2 serology (antibody) testing may be considered medically necessary when performed in the inpatient setting and criteria are met.

    SARS-CoV-2 serology (antibody) testing is considered not medically necessary:

    • As the sole test for COVID-19 diagnosis
    • For any scenario not described in the policy

    Effective June 1, 2020

    Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome, 7.01.101

    Policy replacement and renumber

    • This policy replaces policy 7.01.554
    • The policy has been renumbered to 7.01.101
    • All other statements remain unchanged

    Revised medical policies

    Effective June 1, 2020

    Electrical Stimulation Devices, 1.01.507

    Additions to investigational services

    • H-wave stimulation
    • Transcutaneous electrical stimulator headband (Cefaly®) for the prevention and treatment of migraine headaches and for all other indications

    New pharmacy policies

    Effective June 1, 2020

    Folate Antimetabolites, 5.01.617
    This is a new policy. The following drugs have been added and may be considered medically necessary when criteria are met:

    Otrexup® (methotrexate) and Rasuvo® (methotrexate)

    • Treatment of rheumatoid arthritis (RA) or polyarticular juvenile idiopathic arthritis (pJIA)
    • Treatment of adults with psoriasis

    Trexall® (methotrexate)

    • When the patient has tried and failed a 3-month trial or is unable to tolerate generic methotrexate tablets

    Xatmep® (methotrexate)

    • Treatment of acute lymphoblastic leukemia (ALL) in patients under age 18
    • Treatment of polyarticular juvenile idiopathic arthritis (pJIA) in patients under age 18

    Revised pharmacy policies

    Effective June 1, 2020

    BRAF and MEK Inhibitors, 5.01.589
    The following drugs have been added and may be considered medically necessary when criteria are met:

    Braftovi® (encorafenib) and Erbitux® (cetuximab) combination therapy

    • Treatment of metastatic colorectal cancer (CRC) with a BRAF V600E mutation in adults

    An archived policy is one that's no longer active and is not used for reviews.

    Effective July 2, 2020

    Site of Service - Select Surgical Procedures, 11.01.524

    • Site of service medical necessity review criteria may be found using the applicable medical necessity criteria for the procedure

    A deleted policy is one whose number is no longer used but the content is either moved into another criteria set or replaced with a new policy and number.

    Deleted June 1, 2020

    Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome, 7.01.554

    • The policy has been renumbered 7.01.101

    Added codes

    Effective May 27, 2020

    SARS-CoV-2 Serology (Antibody) Testing, 2.04.518
    Now requires review for medical necessity.

    86328, 86769


    Effective June 1, 2020

    Eyelid Thermal Pulsation for the Treatment of Dry Eye Syndrome, 9.03.29
    Now requires review for investigative.

    0507T

    Miscellaneous Oncology Drugs, 5.01.540
    Now requires review for medical necessity and prior authorization.

    J9145

    Spravato™ (esketamine) Nasal Spray, 5.01.609
    Now requires review for medical necessity and prior authorization.

    G2082, G2083

    Removed codes

    Effective June 1, 2020

    Cognitive Rehabilitation, 8.03.10
    No longer requires review for medical necessity and prior authorization.

    97129, 97130

    Knee Arthroplasty in Adults, 7.01.550
    No longer requires review for medical necessity and prior authorization.

    27445

  • Updates for non-individual plans only

  • InterQual Criteria: Services Reviewed for Medical Necessity, 10.01.531
    This policy outlines the specific services for which the Plan will use InterQual® criteria to review for medical necessity starting for dates of service July 2, 2020 and after. (* InterQual® criteria may vary from the medical policies listed below). Sign in to our website to view InterQual® criteria.

    • Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses, 1.01.11
    • Allogeneic Hematopoietic Cell Transplantation for Genetic Diseases and Acquired Anemias, 8.01.22
    • Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms, 8.01.21
    • Artificial Intervertebral Disc: Cervical Spine, 7.01.108
    • Artificial Pancreas Device Systems, 1.01.30
    • Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions, 7.01.570
    • Bariatric Surgery, 7.01.516
    • Blepharoplasty, Blepharoptosis and Brow Ptosis Surgery, 7.01.508
    • Cardioverter-Defibrillator Placement, 2.02.506
    • Cervical Spine Surgeries: Discectomy, Laminectomy, and Fusion in Adults, 7.01.560
    • Cochlear Implant, 7.01.05
    • Continuous Passive Motion in the Home Setting, 1.01.10
    • Coronary Angiography for Known or Suspected Coronary Artery Disease, 2.02.507
    • Deep Brain Stimulation, 7.01.63
    • Extracorporeal Photopheresis, 8.01.36
    • Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions, 2.01.40
    • Facet Joint Denervation, 7.01.555
    • Gastric Electrical Stimulation, 7.01.522
    • Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma, 8.01.15
    • Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia, 8.01.30
    • Hematopoietic Cell Transplantation for Hodgkin Lymphoma, 8.01.29
    • Hematopoietic Cell Transplantation for Non-Hodgkin Lymphoma, 8.01.529
    • Hematopoietic Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS Syndrome, 8.01.17
    • Hematopoietic Cell Transplantation in the Treatment of Germ-Cell Tumors, 8.01.532
    • Hip Arthroplasty in Adults, 7.01.573
    • Hospital Beds and Accessories, 1.01.520
    • Hyperbaric Oxygen Therapy, 2.01.505
    • Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers), 7.01.107
    • Interspinous Fixation (Fusion) Devices, 7.01.138
    • Kidney Transplant, 7.03.01
    • Knee Arthroplasty in Adults, 7.01.550*
    • Knee Arthroscopy in Adults, 7.01.549
    • Knee Orthoses (Braces), Ankle-Foot-Orthoses, and Knee-Ankle-Foot-Orthoses, 1.03.501
    • Liver Transplant and Combined Liver-Kidney Transplant, 7.03.509*
    • Lumbar Spinal Fusion, 7.01.542
    • Lumbar Spine Decompression Surgery: Discectomy, Foraminotomy, Laminotomy, Laminectomy in Adults, 7.01.551
    • Magnetic Resonance-Guided Focused Ultrasound, 7.01.109
    • Mastectomy for Gynecomastia, 7.01.521*
    • Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Conditions, 1.01.15
    • Panniculectomy and Excision of Redundant Skin, 7.01.523
    • Patient Lifts, Seat Lifts and Standing Devices, 1.01.519
    • Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, 2.02.26
    • Percutaneous Vertebroplasty and Sacroplasty, 6.01.25
    • Pneumatic Compression Pumps for Treatment of Lymphedema and Venous Ulcers, 1.01.18
    • Power Operated Vehicles (Scooters) (Excluding Motorized Wheelchairs), 1.01.527
    • Radioembolization for Primary and Metastatic Tumors of the Liver, 8.01.521
    • Reconstructive Breast Surgery/Management of Breast Implants, 7.01.533
    • Reduction Mammaplasty for Breast-Related Symptoms, 7.01.503*
    • Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy, 7.01.143
    • Rhinoplasty, 7.01.558
    • Sacral Nerve Neuromodulation/Stimulation, 7.01.69
    • Semi-Implantable and Fully Implantable Middle Ear Hearing Aids, 7.01.84
    • Spinal Cord and Dorsal Root Ganglion Stimulation, 7.01.546
    • Transcatheter Aortic Valve Implantation for Aortic Stenosis, 7.01.132
    • Transcatheter Arterial Chemoembolization (TACE) as a Treatment for Primary or Metastatic Liver Malignancies, 8.01.11
    • Transcatheter Mitral Valve Repair, 2.02.30
    • Vagus Nerve Stimulation, 7.01.20
    • Wearable Cardioverter-Defibrillators as a Bridge to Implantable Cardioverter-Defibrillator Placement, 2.02.506
    • Wheelchairs (Manual or Motorized), 1.01.501

    No updates this month

  • Updates for individual plans only

  • Services Reviewed Using InterQual Criteria, 10.01.530
    This policy outlines the specific services for which the Plan will use InterQual® criteria with those added for dates of service beginning July 2, 2020 and after. (* InterQual® criteria may vary from the medical policies listed below). Sign in to our website to view InterQual® criteria.

    • Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses, 1.01.11
    • Allogeneic Hematopoietic Cell Transplantation for Genetic Diseases and Acquired Anemias, 8.01.22
    • Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms, 8.01.21
    • Artificial Intervertebral Disc: Cervical Spine, 7.01.108
    • Artificial Pancreas Device Systems, 1.01.30
    • Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions, 7.01.570
    • Bariatric Surgery, 7.01.516
    • Blepharoplasty, Blepharoptosis and Brow Ptosis Surgery, 7.01.508
    • Cardioverter-Defibrillator Placement, 2.02.506
    • Cervical Spine Surgeries: Discectomy, Laminectomy, and Fusion in Adults, 7.01.560
    • Cochlear Implant, 7.01.05
    • Continuous Passive Motion in the Home Setting, 1.01.10
    • Coronary Angiography for Known or Suspected Coronary Artery Disease, 2.02.507
    • Deep Brain Stimulation, 7.01.63
    • Extracorporeal Photopheresis, 8.01.36
    • Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions, 2.01.40
    • Facet Joint Denervation, 7.01.555
    • Gastric Electrical Stimulation, 7.01.522
    • Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma, 8.01.15
    • Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia, 8.01.30
    • Hematopoietic Cell Transplantation for Hodgkin Lymphoma, 8.01.29
    • Hematopoietic Cell Transplantation for Non-Hodgkin Lymphoma, 8.01.529
    • Hematopoietic Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS Syndrome, 8.01.17
    • Hematopoietic Cell Transplantation in the Treatment of Germ-Cell Tumors, 8.01.532
    • Hip Arthroplasty in Adults, 7.01.573
    • Hospital Beds and Accessories, 1.01.520
    • Hyperbaric Oxygen Therapy, 2.01.505
    • Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers), 7.01.107
    • Interspinous Fixation (Fusion) Devices, 7.01.138
    • Kidney Transplant, 7.03.01
    • Knee Arthroplasty in Adults, 7.01.550*
    • Knee Arthroscopy in Adults, 7.01.549
    • Knee Orthoses (Braces), Ankle-Foot-Orthoses, and Knee-Ankle-Foot-Orthoses, 1.03.501
    • Liver Transplant and Combined Liver-Kidney Transplant, 7.03.509*
    • Lumbar Spinal Fusion, 7.01.542
    • Lumbar Spine Decompression Surgery: Discectomy, Foraminotomy, Laminotomy, Laminectomy in Adults, 7.01.551
    • Magnetic Resonance-Guided Focused Ultrasound, 7.01.109
    • Mastectomy for Gynecomastia, 7.01.521*
    • Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Conditions, 1.01.15
    • Panniculectomy and Excision of Redundant Skin, 7.01.523
    • Patient Lifts, Seat Lifts and Standing Devices, 1.01.519
    • Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, 2.02.26
    • Percutaneous Vertebroplasty and Sacroplasty, 6.01.25
    • Pneumatic Compression Pumps for Treatment of Lymphedema and Venous Ulcers, 1.01.18
    • Power Operated Vehicles (Scooters) (Excluding Motorized Wheelchairs), 1.01.527
    • Radioembolization for Primary and Metastatic Tumors of the Liver, 8.01.521
    • Reconstructive Breast Surgery/Management of Breast Implants, 7.01.533
    • Reduction Mammaplasty for Breast-Related Symptoms, 7.01.503*
    • Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy, 7.01.143
    • Rhinoplasty, 7.01.558
    • Sacral Nerve Neuromodulation/Stimulation, 7.01.69
    • Semi-Implantable and Fully Implantable Middle Ear Hearing Aids, 7.01.84
    • Spinal Cord and Dorsal Root Ganglion Stimulation, 7.01.546
    • Transcatheter Aortic Valve Implantation for Aortic Stenosis, 7.01.132
    • Transcatheter Arterial Chemoembolization (TACE) as a Treatment for Primary or Metastatic Liver Malignancies, 8.01.11
    • Transcatheter Mitral Valve Repair, 2.02.30
    • Treatment of Varicose Veins/Venous Insufficiency, 7.01.519
    • Upper Gastrointestinal (UGI) Endoscopy for Adults, 2.01.533
    • Vagus Nerve Stimulation, 7.01.20
    • Wearable Cardioverter-Defibrillators as a Bridge to Implantable Cardioverter-Defibrillator Placement, 2.02.506
    • Wheelchairs (Manual or Motorized), 1.01.501

    No updates this month

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