Medical Policy Updates

Table Of Contents

Notification of Policy Revisions Effective May 5, 2005 (Posted March 3, 2005)

Medical Policy Revision
Co-Surgeon, Assistant Surgeon, and Physician Assistant Guidelnes For consistency added " Blue Care, Blue Choice, Blue Options and Classic Blue to the Policy statement. Policy changed to state "Blue Cross and Blue Shield of North Carolina uses the American College of Surgeons as its primary source for determining those procedures available for assistant surgeon benefits" for Blue Care, Blue Choice, Blue Options and Classic Blue Products. Policy guidelines changed to "When multiple procedures are performed and the secondary procedures are allowable according to the multiple procedure guidelines, but not individually eligible for assistant surgeon services, benefits for those services may be allowed on an individual consideration basis." and "On occasion, a procedure not allowed assistant surgeon benefits may be unusually complex for a particular patient and warrant assistant surgeon services. These cases will be reviewed on an individual consideration basis." Notice given 03/03/2005. Effective date 05/05/2005.
Psychiatric Care Additional information added to "When covered" regarding "Family Therapy". Under "When not covered" added "Multifamily therapy" and "Hypnosis is not covered for the treatment of mental health conditions, alcoholism, drug or chemical dependency, or other health conditions such as obesity. Hypnosis is only covered for control of acute or chronic pain." "Counseling with relatives about a patient with mental illness, alcoholism, drug addiction or chemical dependency. This does not exclude family counseling with the patient present. Policy Guidelines added related to hypnotherapy. Notice given 3/3/05. Effective date of policy 5/5/05.
Ultrasonographic Evaluation of Skin Lesions Notification of new policy. BCBSNC will not provide coverage for Ultrasonographic evaluation of skin lesions. This service is considered investigational and BCBSNC does not cover investigational services. Ultrasonographic evaluation as a technique to assess photoaging or skin rejunvenation techniques is considered cosmetic in nature and therefore not medically necessary. Notification given 3/3/05. Effective date 5/5/05.