Medical Policy Updates

Table Of Contents

Notification of Policy Revisions Effective March 12, 2013 (Posted December 11, 2012)

Medical Policy Revision
Aqueous Shunts and Devices for Glaucoma "Notification" Revised the description and policy guidelines sections. Under "When Not Covered" section added investigational statement: "Use of a micro-stent is considered investigational." Notification given 12/11/12 for effective date 3/12/13.
Intraepidermal Nerve Fiber Density "Notification" Name changed from Intraepidermal Nerve Fiber Density to Nerve Fiber Density Testing. Description section revised. New indication added to the When Not Covered section to state; "Measurement of sweat gland nerve fiber density is considered investigational." Policy Guidelines updated. Reference added. Senior Medical Director review 11/26/12. Notification given 12/11/12. Policy effective 3/12/13.
Surgery for Morbid Obesity "Notification" Added "Two-stage bariatric surgery procedures (e.g., sleeve gastrectomy as initial procedure followed by biliopancreatic diversion at a later time)" to the When Surgery for Morbid Obesity is Not Covered section. Added information related to 2-stage bariatric surgery procedures to the Policy Guidelines section. Notification given 12/11/12. Policy effective 3/12/13.