Medical Policy Updates

Table Of Contents

Notification of Policy Revisions Effective August 13, 2013 (Posted June 11, 2013)

Medical Policy Revision
Cardiovascular Disease Risk Tests "Notification" Policy statement revised to state: "Measurement of cardiovascular risk factors (i.e., apolipoprotein B, apolipoprotein A-I, apolipoprotein E, LDL subclass, HDL subclass, lipoprotein[a], lipoprotein-associated phospholipase A2 [Lp-PLA2], genomic markers including genotyping for 9p21 SNPs, rs3798220 allele, and KIF6 , hereditary hypercoagulability factors, long chain fatty acids, fibrinogen, cystatin C) is considered investigational as an adjunct to LDL cholesterol in the risk assessment and management of cardiovascular disease. BCBSNC does not provide coverage for investigational services or procedures." "When not Covered" section updated to include the following statements: "Measurement of cardiovascular risk factors (i.e., apolipoprotein B, apolipoprotein A-I, apolipoprotein E, LDL subclass, HDL subclass, lipoprotein[a], long chain fatty acids, fibrinogen, genomic markers, cystatin C) is considered investigational as an adjunct to LDL cholesterol in the risk assessment and management of cardiovascular disease." and "Measurement of hereditary hypercoagulability factors is considered investigational for predicting cardiovascular disease risk." Description section updated. Policy Guidelines updated. Added the following CPT codes to the Billing/Coding section: 81250, 81241, 81400, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81408. Medical Director review 5/2013. Notification given June 11, 2013 for effective date August 13, 2013.