Medical Policy Updates

Notification of Policy Revisions Effective June 16, 2005 (Posted April 7, 2005)

Medical Policy	Revision
Patient Lifts	Specialty Matched Consultant Advisory Panel [MPAG] review on 3/10/2005. No changes made to policy criteria. MPOC review and discussion on 2/14/05. Description section broadened to clarify different types of lift devices. Policy section rewritten to include that BCBSNC does not provide coverage for Electric Patient Lifts, Seat Lift Mechanisms or Ceiling Lifts because they are considered convenience items and therefore not medically necessary. When Patient Lifts are Covered section revised to indicate that repair, adjustment, or replacement of parts and accessories necessary for the normal and effective functioning of the patient lift equipment is covered if all the above criteria is met. When Patient Lifts are Not Covered section revised to clarify noncoverage for: 1) equipment that serves as a comfort or convenience item, 2) electrical or mechanical features which enhance basic equipment which usually serve a convenience function, or 3) repair, adjustment, or replacement of parts and accessories for Seat Lift Mechanisms or Ceiling Lifts. Also included for noncoverage are Stairglides, Van Lifts, and Wheel-O-Vators. Billing/Coding section updated to include E codes: E0621, E0625, E0627, E0628, E0629, E0636, E0637, and E0638. Medical terms expanded to include Hydraulic lifts, Ceiling lifts, Seat Lift Mechanism, Electric lift, DME0215. Reference added. Notification 4/7/2005. Effective 6/16/2005.
Rapid Flu Tests in the Outpatient Setting	New policy issued. Rapid Flu Tests in the Outpatient Setting is considered investigational. Testing performed in the ER or Urgent Care settings does not apply to this policy. Specialty Matched Advisory Panel [MPAG] review on 03/10/2005 with no changes made to policy criteria. MPOC review and discussion on 02/14/05. References added. Notification 4/7/2005. Effective 6/16/ 2005.

Medical Policy

Revision

Patient Lifts

Specialty Matched Consultant Advisory Panel [MPAG] review on 3/10/2005. No changes made to policy criteria. MPOC review and discussion on 2/14/05. Description section broadened to clarify different types of lift devices. Policy section rewritten to include that BCBSNC does not provide coverage for Electric Patient Lifts, Seat Lift Mechanisms or Ceiling Lifts because they are considered convenience items and therefore not medically necessary. When Patient Lifts are Covered section revised to indicate that repair, adjustment, or replacement of parts and accessories necessary for the normal and effective functioning of the patient lift equipment is covered if all the above criteria is met. When Patient Lifts are Not Covered section revised to clarify noncoverage for: 1) equipment that serves as a comfort or convenience item, 2) electrical or mechanical features which enhance basic equipment which usually serve a convenience function, or 3) repair, adjustment, or replacement of parts and accessories for Seat Lift Mechanisms or Ceiling Lifts. Also included for noncoverage are Stairglides, Van Lifts, and Wheel-O-Vators. Billing/Coding section updated to include E codes: E0621, E0625, E0627, E0628, E0629, E0636, E0637, and E0638. Medical terms expanded to include Hydraulic lifts, Ceiling lifts, Seat Lift Mechanism, Electric lift, DME0215. Reference added. Notification 4/7/2005. Effective 6/16/2005.

Rapid Flu Tests in the Outpatient Setting

New policy issued. Rapid Flu Tests in the Outpatient Setting is considered investigational. Testing performed in the ER or Urgent Care settings does not apply to this policy. Specialty Matched Advisory Panel [MPAG] review on 03/10/2005 with no changes made to policy criteria. MPOC review and discussion on 02/14/05. References added. Notification 4/7/2005. Effective 6/16/ 2005.