Medical Policy Updates

Table Of Contents

Notification of Policy Revisions Effective December 31, 2013 (Posted October 29, 2013)

Medical Policy Revision
Capsule Endoscopy, Wireless "Notification" Reference added. Ulcerative colitis, acute GI bleeding and Lynch syndrome added to investigational policy statement. Medical Director review. Notification given 10/29/13 for policy effective date 12/31/13.
Chiropractic Services "Notification" Added "14. Kinesiology taping is considered investigational." to the When Not Covered section. Added the following statement to the Billing and Coding section to indicate; "Strapping codes (29200 - 29280, 29520 - 29580, and 29799) are only used for immobilization and should not be used for kinesiology taping." Senior Medical Director review 10/11/2013. Reference added. Notification given 10/29/2012. Policy effective 12/31/2013.
Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins during Breast-Conserving Surgery "Notification" New policy developed. Handheld radiofrequency spectroscopy for intraoperative assessment of surgical margins during breast-conserving surgery is considered investigational. Medical Director review 9/2013. Notification given 10/29/13 for policy effective date 12/31/13.
Immune Globulin Therapy "Notification" Reference added. Medical Director review. Severe anemia due to parvovirus B19 added as medically necessary. Opsoclonus-myoclonus, birdshot retinopathy, epidermolysis bullosa acquisita, necrotizing fasciitis and polyradiculoneuropathy (other than CIDP) added as investigational. Notification given 10/29/13 for policy effective date of 12/31/13.