Medical Policy and Coding Updates October 2021

  • Updates for both non-individual and individual plans

  • Effective January 7, 2022

    Cervical Spine Surgeries: Discectomy, Laminectomy, and Fusion in Adults, 7.01.560

    Medical necessity criteria updated

    • Site of service (off campus-outpatient hospital/medical center, on campus-outpatient hospital/medical center, and ambulatory surgical center) has been added to the policy for medical necessity review for single-level cervical decompressions and single level cervical fusions (CPT codes 22551, 22554, 22600, 63020, and 63045)

    Hysterectomy for Non-Malignant Conditions, 7.01.548

    New policy

    • Hysterectomy, with or without salpingo-oophorectomy (removal of fallopian tubes and ovaries) is considered medically necessary when criteria are met
    • Conditions included in the criteria: abnormal uterine bleeding or uterine fibroids (leiomyomata), adenomyosis, endometriosis, genetic predisposition to cancer, symptomatic pelvic organ prolapse
    • Conditions excluded from review are hysterectomy for malignancies or conditions highly suspicious for malignancy (eg, ovarian mass) and hysterectomy for gender-transition/affirming surgeries
    • Site of Service review is included for laparoscopic-assisted vaginal hysterectomy and vaginal hysterectomy

    Lumbar Spinal Fusion, 7.01.542

    Medical necessity criteria updated

    • Site of service (off campus-outpatient hospital/medical center, on campus-outpatient hospital/medical center, and ambulatory surgical center) has been added to the policy for medical necessity review for single-level lumbar fusions (CPT codes 22553, 22558, 22612, 22630, and 22633)

    Site of Service: Select Surgical Procedures, 11.01.524

    • Single-level cervical discectomy and lumbar spinal fusions, along with some hysterectomy procedures, have been added to this policy as now requiring site of service review for medical necessity and are indicated by the following codes: 22533, 22551, 22554, 22558, 22600, 22612, 22630, 22633, 58260, 58262, 58263, 58267, 58270, 58275, 58280, 58290, 58291, 58292, 58294, 58550,58552, 58553, 58554,63020 and 63045. HCPCS code C1726 was removed

    Effective December 2, 2021

    Pharmacotherapy of Miscellaneous Autoimmune Diseases, 5.01.564

    New drug added to policy

    • Arcalyst® (rilonacept)
      • Treatment of cryopyrin-associated period syndromes (CAPS) in adults and children age 12 and older
      • Treatment of deficiency of interleukin-1 receptor antagonist (DIRA) in adults and children weighing at least 10 kg
      • Treatment of recurrent pericarditis (RP) in patients age 12 and older

    Effective November 5, 2021

    Allograft Injection for Degenerative Disc Disease, 7.01.166

    New policy

    • Injecting a tissue graft from a donor into the space between the spinal vertebrae as a treatment of degenerative joint disease is considered investigational 

    Medical Necessity Criteria for Pharmacy Edits, 5.01.605

    Testosterone Replacement Products

    New drug added to policy

    • Aveed® (testosterone undecanoate)

    Miscellaneous Oncology Drugs, 5.01.540

    New drugs added to policy

    • Abraxane® (paclitaxel protein-bound particles)
      • Treatment of metastatic breast cancer
      • Treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC)
      • Treatment of metastatic adenocarcinoma of the pancreas
    • Arranon® (nelarabine)
      • Treatment of T-cell acute lymphoblastic lymphoma (T-ALL)
      • Treatment of T-cell lymphoblastic lymphoma (T-LBL)
    • Empliciti® (elotuzumab)
      • Treatment of multiple myeloma
    • Erwinaze® (asparaginase erwinia chrysanthemi)
      • As a part of a multi-agent chemotherapy regimen for the treatment of acute lymphoblastic leukemia (ALL)
    • Halaven® (eribulin mesylate)
      • Treatment of metastatic breast cancer
      • Treatment of inoperable or metastatic liposarcoma
    • Yondelis® (trabectedin)
      • Treatment of inoperable or metastatic liposarcoma or leiomyosarcoma

    Non-covered Experimental/Investigational Services, 10.01.533

    New policy

    • The safety and/or effectiveness of treatments, procedures, equipment, drugs, drug usage, medical devices, or supplies that have not been supported by a review of published medical and scientific literature are considered experimental/investigational
    • This policy lists several services that are considered experimental/investigational

    New medical policies

    Effective October 1, 2021

    Diagnosis and Treatment of Sacroiliac Joint Pain, 6.01.527

    • This policy replaces Diagnosis and Treatment of Sacroiliac Joint Pain, 6.01.23
    • Injection of an anesthetic for the purpose of diagnosing sacroiliac joint pain has been removed from the policy

    Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis, 1.01.525

    • This policy replaces Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis, 1.01.28
    • Intolerance to heparin preparations (eg, previous allergic reaction or adverse event) has been added as a contraindication for using standard anticoagulant medications

    Prescription Digital Therapeutics for Attention Deficit/Hyperactivity Disorder, 3.03.03

    • Prescription digital therapeutics for the treatment of attention deficit/hyperactivity disorder (ADHD) are considered investigational

    Revised medical policies

    Effective October 1, 2021

    Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Select Intra-Abdominal and Pelvic Malignancies, 2.03.07

    Medical necessity criteria updated

    • The requirement of a cis-platinum chemotherapy agent for cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC) has been removed

    Magnetic Resonance Imaging-Guided Focused Ultrasound, 7.01.109

    Investigational criteria updated

    • Medication-refractory tremor dominant Parkinson's disease has been added to the list of investigational treatments

    Rhinoplasty, 7.01.558

    Investigational criteria updated

    • Radiofrequency treatment for nasal airway remodeling is considered investigational for the treatment of airway obstruction (eg, VivAer® Stylus)

     

    New pharmacy policies

    Effective October 1, 2021  

    Amyloid Antibodies for the Treatment of Alzheimer's Disease, 5.01.626

    • Aduhelm™ (aducanumab) is considered investigational for all indications, including the treatment of Alzheimer's disease    

    Revised pharmacy policies

    Effective October 1, 2021  

    C5 Complement Inhibitors, 5.01.571

    Policy renamed

    • From "C5 Complement Inhibitors" to "C3 and C5 Complement Inhibitors"

    New drug added

    • Empaveli™ (pegcetacoplan)
      • Treatment of paroxysmal nocturnal hemoglobinuria (PNH) 
      • Added to length of approval criteria for initial and re-authorization  

    IL-5 Inhibitors, 5.01.559

    Medical necessity criteria updated

    • Nucala® (mepolizumab)
      • Treatment of chronic rhinosinusitis with nasal polyps (CRSwNP)
      • Re-authorization may be approved up to 1 year  

    Immune Checkpoint Inhibitors, 5.01.591

    Medical necessity criteria updated

    • Jemperli® (dostarlimab-gxly)
      • Treatment of mismatch repair deficient (dMMR) recurrent or advanced solid tumors
    • Keytruda® (pembrolizumab)
      • First-line treatment of advanced RCC in combination with Lenvima® (lenvatinib)
    • Opdivo® (nivolumab)
      •  Adjuvant treatment of urothelial carcinoma (UC) at high risk of recurrence after undergoing radical resection of UC  

    Medical Necessity Criteria for Pharmacy Edits, 5.01.605

    Dry Eye Treatments

    New drug added

    • Eysuvis™ (loteprednol etabonate ophthalmic suspension)  

    Heart Failure Agents

    New drug added

    • Jardiance® (empagliflozin)  

    Miscellaneous Oncology Drugs, 5.01.540

    New drug added

    • Welireg™ (belzutifan)
      •  Treatment of adult patients with von Hippel-Lindau (VHL) disease

    Medical necessity criteria updated

    • Tibsovo® (ivosidenib)
      • Treatment of previously treated locally advanced or metastatic cholangiocarcinoma with an IDH1 mutation
      • Treatment of newly diagnosed AML who are ≥ 75 years old or who have comorbidities

    • Darzalex Faspro™ (daratumumab and hyaluronidase-fihj)
      • Treatment of multiple myeloma in combination with Pomalyst® (pomalidomide) and dexamethasone
    • Padcev™ (enfortumab vedotin-ejfv)
      • Treatment of metastatic urothelial cancer  

    Multiple Receptor Tyrosine Kinase Inhibitors, 5.01.534

    Medical necessity criteria updated

    • Lenvima® (lenvatinib)
      • First-line treatment of advanced renal cell carcinoma (RCC) in combination with Keytruda® (pembrolizumab)  

    Pharmacologic Treatment of Sleep Disorders, 5.01.599

    Medical necessity criteria updated

    • Xywav® (calcium magnesium, potassium, and sodium oxybates)
      • Treatment of idiopathic hypersomnia
      • Re-authorization criteria of Xywav® (calcium magnesium, potassium, and sodium oxybates) now includes the diagnosis of idiopathic hypersomnia as documented by a prior sleep study

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

    Effective October 1, 2021

    Cognitive Rehabilitation, 8.03.10

    In Vitro Chemoresistance and Chemosensitivity Assays, 2.03.01

    Three-Dimensional Printed Orthopedic Implants, 7.01.161

    Effective October 1, 2021

    Diagnosis and Treatment of Sacroiliac Joint Pain, 6.01.23

    • This policy is replaced with Diagnosis and Treatment of Sacroiliac Joint Pain, 6.01.527

    Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis, 1.01.28

    • This policy is replaced with Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis, 1.01.525

    Added codes

    Effective October 1, 2021

    AIM Specialty Health® Genetic Testing

    Now reviewed by AIM® Specialty Health and requires prior authorization.

    0258U, 0260U, 0262U, 0264U

    Amniotic Membrane and Amniotic Fluid, 7.01.583

    Now requires review for investigative.

    Q4251, Q4252, Q4253

    Antibody-Drug Conjugates, 5.01.582

    Now requires review for medical necessity.

    C9084

    Chimeric Antigen Receptor Therapy for Leukemia and Lymphoma, 8.01.63

    Now requires review for medical necessity and prior authorization.

    Q2054

    Chimeric Antigen Receptor Therapy for Leukemia and Lymphoma, 8.01.63

    Now requires review for medical necessity.

    C9081

    Cryoablation of Tumors Located on the Kidney, Lung, Breast, Pancreas or Bone, 7.01.92

    Now requires review for investigative.

    19105, 0581T 

    Cutaneous T-Cell Lymphomas (CTCL): Systemic Therapies, 5.01.532

    Now requires review for medical necessity and prior authorization.

    J9318, J9319

    Electrical Stimulation Devices, 1.01.507

    Now requires review for medical necessity and prior authorization.

    K1023

    Epidermal Growth Factor Receptor (EGFR) Inhibitors, 5.01.603

    Now requires review for medical necessity.

    C9083

    Gender Reassignment Surgery, 7.01.557

    Now requires review for medical necessity and prior authorization.

    57335

    Immune Checkpoint Inhibitors, 5.01.591

    Now requires review for medical necessity.

    C9082

    Lumbar Spinal Fusion, 7.01.542

    Now requires review for medical necessity.

    C8131

    Magnetic Resonance Imaging-Guided Focused Ultrasound, 7.01.109

    Now requires review for medical necessity.

    C9734

    Miscellaneous Oncology Drugs, 5.01.540

    Now requires review for medical necessity and prior authorization.

    J1448, J9247, J9281

    Nerve Repair for Peripheral Nerve Injuries Using Synthetic Conduits or Allografts, 7.01.584

    Now requires review for investigative and prior authorization.

    64910, 64912, 64913

    Nerve Repair for Peripheral Nerve Injuries Using Synthetic Conduits or Allografts, 7.01.584

    Now requires review for investigative.

    C9352, C9353, C9355, C9361

    Pharmacologic Treatment of Duchenne Muscular Dystrophy, 5.01.570

    Now requires review for medical necessity and prior authorization.

    J1426

    Pharmacologic Treatment of High Cholesterol, 5.01.558

    Now requires review for medical necessity and prior authorization.

    J1305

    Radioembolization for Primary and Metastatic Tumors of the Liver, 8.01.43

    Now requires review for medical necessity.

    C2616


    Revised codes

    Effective October 1, 2021

    Diagnosis and Treatment of Sacroiliac Joint Pain, 6.01.527

    Now requires review for investigative and prior authorization.

    27280 


    Removed codes

    Effective October 1, 2021

    Amniotic Membrane and Amniotic Fluid, 7.01.583

    No longer requires review for investigative.

    Q4228, Q4236

    Chimeric Antigen Receptor Therapy for Leukemia and Lymphoma, 8.01.63

    No longer requires review for investigative.

    C9076

    Cutaneous T-Cell Lymphomas (CTCL): Systemic Therapies, 5.01.532

    No longer requires review for medical necessity.

    C9065

    Cutaneous T-Cell Lymphomas (CTCL): Systemic Therapies, 5.01.532

    No longer requires review for medical necessity and prior authorization.

    J9315

    Diagnosis and Treatment of Sacroiliac Joint Pain, 6.01.527

    No longer requires review for investigative.

    64451

    In Vitro Chemoresistance and Chemosensitivity Assays, 2.03.01

    No longer requires review for investigative. Policy archived.

    81535, 81536

    Miscellaneous Oncology Drugs, 5.01.540

    No longer requires review for medical necessity and prior authorization.

    J9280

    Miscellaneous Oncology Drugs, 5.01.540

    No longer requires review for medical necessity.

    C9078, C9080

    Pharmacologic Treatment of Duchenne Muscular Dystrophy, 5.01.570

    No longer requires review for medical necessity.

    C9075

    Pharmacologic Treatment of High Cholesterol, 5.01.558

    No longer requires review for medical necessity.

    C9079

  • Updates for non-individual plans only

  • No updates this month

    No updates this month

  • Updates for individual plans only

  • No updates this month
    No updates this month
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