Medical Policy Updates

Table Of Contents

Blue Cross and Blue Shield of North Carolina Medical Policy Update for March 6, 2012

Medical Guidelines Reason for Update
Canalith Repositioning for Benign Paroxysmal Positional Vertigo Medical Director review 2/5/12. Archive policy.
ECG Reimbursement Issues Policy returned to "active review" status. The following was added to the Principles section Item 4. "Global only" codes represent a routine ECG with at least 12 leads and include the physician's interpretation and report. Other CPT codes are established to specify the "technical" component, (the ECG tracing only), and the "professional" component (for interpretation and report only). It is not appropriate to use modifiers -26 or - TC with these latter codes. Item 5. When Rhythm ECG, interpretation and report only, is billed the same date as an Evaluation and Management service in the hospital setting, then the rhythm ECG will be denied as a component of the Evaluation and Management service.
Genetic testing for Non-malignant Inherited Disorders Added codes 81220, 81221, 81222, 81223, 81224, 96040, S0265to the "Billing/Coding" section. Added a reference to the following policy in the "Description" section: "Genetic Testing for Predisposition to Inherited Hypertrophic Cardiomyopathy."
Kappa Lambda Clonal Excess Medical Director review 2/5/12. Archive policy.
Modifier Guidelines Revised the definitions of the modifiers. The sections formerly titled "when a modifier may be covered" and "when modifiers may not be covered" were combined into one section titled "when a modifier may affect claims payment." Information added to the Policy Guidelines section regarding fracture care codes and anesthesia modifiers.
Thoracoscopic Laser Ablation of Emphysematous Pulmonary Bullae Policy reviewed by Medical Director 2/19/12. Archive.
Evidence Based Guidelines
Aerosolized Antibiotics as a Treatment of Chronic Sinusitis Medical Director Review 2/5/12. Archive policy.
Fetal Fibronectin References updated. Evidence Based Guideline Section reworded. Medical Evidence regarding Fetal Fibronection Section reworded. No change to policy statement. Medical director review 2/9/12. Archive policy.
Videofluoroscopic Evaluation of Velopharyngeal Closure for Speech Disorders Medical Director review 2/5/12. Archive policy.