Medical Policy Updates

Table Of Contents

Notification of Policy Revisions Effective September 10, 2013 (Posted July 1, 2013)

Medical Policy Revision
Surgery for Morbid Obesity "Notification" Added the following to the General Criteria for Adults and Adolescents in the Policy Guidelines section; "5. To determine whether or not patients have responded to conservative measures for weight reduction, patients must have been active participants in non-surgical weight reduction programs that include frequent, e.g., monthly, documentation of weight, dietary regimen, and exercise, for at least 6 months prior to consideration for bariatric surgery. These conservative attempts must be reviewed by the practitioner seeking approval for the surgical procedure." Notification given 7/1/2013. Policy effective 9/10/2013.
Vertebroplasty, Kyphoplasty, and Sacroplasty Percutaneous "Notification" Description and Policy Guidelines updated. Added the following statement to the When Not Covered section; "Percutaneous mechanical vertebral augmentation using any other device, in-cluding but not limited to Kiva®, is considered investigational." Specialty Matched Consultant Advisory Panel review 5/15/2013. References added. Notification given 7/1/2013. Policy effective 9/10/2013.