May 2018 Medical Policy & Pharmacy Policy Updates:
- *Facility Routine Services, Supplies and Equipment (R12)
- *Pharmacy and Infusion Services (R14)
- Laser Interstitial Thermal Therapy – (0528)
- Cognitive Rehabilitation – (0124)
- Mechanical Devices for the Treatment of Back Pain – (0140)
- Negative Pressure Wound Therapy/Vacuum-Assisted Closure (VAC) for Non-Healing Wounds – (0064)
- Phototherapy, Photochemotherapy, and Excimer Laser Therapy for Dermatologic Conditions – (0031)
- Home Traction Devices: Cervical and Lumbar – (0265) Archived
- Home Traction Devices – Cervical and Lumbar – (CPG 265)
- Low-Level Laser Therapy – (0115) Archived
- Low-Level Laser and High-Power Laser Therapy – (CPG 030)
- Acupuncture – (0024) Archived
- Acupuncture – (CPG 024)
- Axial/Spinal Decompression Therapy/Mechanical Traction (Provided in a Clinic Setting) – (CPG 275)
- Triamcinolone Acetonide Extended-Release Injection (Zilretta) – (1811)
- Voretigene neparvovec – (1809)
- Afrezza – (1506)
- Canakinumab – (1110)
- Compounded Medications – (1406)
- Drugs / Biologics Not Covered Unless Approved Under Medical Necessity Review – Employer Group Plans: Standard Prescription Drug List and Performance Prescription Drug List – (1601)
- Drugs / Biologics Not Covered Unless Approved Under Medical Necessity Review – Employer Group Plans: Value Prescription Drug List and Advantage Prescription Drug List – (1602)
- Edaravone – (1806)
- Eteplirsen – (1702)
- Multiple Sclerosis Therapy – (1402)
- Oxazolidinone Antibiotics – (1123)
- Pharmacy Prior Authorization – (1407)
- Step Therapy – (1109)
- Modifier 62, 66, 80, 81, 82 and AS – Assistant Surgeon, Assistant at Surgery, Co-Surgeon (Two Surgeons) and Surgical Team
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