Paramount Healthcare November 2017 Medical Policy Updates

Paramount Healthcare Medical Policy Updates
Paramount Healthcare Medical Policy Updates

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POLICY STATUS REVISION
PG0318 Vision Therapy Revision
PENDING
Effective 2/23/18
11/14/17: Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0181 Topographic Genotyping Revision
PENDING
Effective 2/23/18
11/14/17: Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0311 Gender Reassignment Surgery Revision
PENDING
Effective 2/23/18
11/14/17: Removed ICD-9 codes. Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0384 Drug Eluting Devices for Use Following Endoscopic Sinus Surgery Revision
PENDING
Effective 2/23/18
11/14/17: Policy reviewed and updated to reflect the most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0355 Genetic Testing for Hereditary Thrombophilia Revision
PENDING
Effective 2/23/18
11/14/17: Genetic testing for hereditary thrombophilia (81240, 81241) is now covered with prior authorization for HMO, PPO, Individual Marketplace, & Elite. Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0357 Gene Expression Profiling for Colorectal Cancer Revision
PENDING
Effective 2/23/18
11/14/17:  Removed codes 81479, 84999, & 88299. Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0360 Genetic Testing for FMR1 Mutations Including Fragile X Syndrome Revision
PENDING
Effective 2/23/18
11/14/17: Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0362 Vectra® DA Revision
PENDING
Effective 2/23/18
11/14/17: Removed code 81479. Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0363 CORUS® CAD Revision
PENDING
Effective 2/23/18
11/14/17: Added ICD-10 codes per CMS guidelines. Removed code 81479. Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).
PG0364 Cancer Type ID Revision
PENDING
Effective 2/23/18
11/14/17: Policy reviewed and updated to reflect most current clinical evidence per The Technology Assessment Working Group (TAWG).

 

 

Click here to view the Paramount Healthcare Medical Policy Updates »

 

Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!

Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.

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