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43633
Removal of stomach partial
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43847
PR GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43645
PR LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
S2085
Laparoscop gastric bypass
CPT
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43848
Revision gastroplasty
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43644
PR LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
S2083
PR ADJUSTMENT GASTRIC BAND
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
S2082
Lap adjustable gastric band
CPT
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
43659
HC UNLISTED LAPAROSCOPE PROC STOM
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
43847
PR GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
43645
PR LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
S2085
Laparoscop gastric bypass
CPT
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
S2083
PR ADJUSTMENT GASTRIC BAND
HCPCS
CPT codes 43770-43774, 43886-43888, HCPCS code S2083, ICD-9 procedure codes 44.95, 44.97, 44.98 moved to covered 7/30/2010: Policy description updated to include detailed descriptions of gastric restrictive procedures and malabsorptive procedures. Policy statement section updated to include open or laparoscopic biliopa...
43774
PR LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT
HCPCS
CPT codes 43770-43774, 43886-43888, HCPCS code S2083, ICD-9 procedure codes 44.95, 44.97, 44.98 moved to covered 7/30/2010: Policy description updated to include detailed descriptions of gastric restrictive procedures and malabsorptive procedures. Policy statement section updated to include open or laparoscopic biliopa...
43888
PR GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT
HCPCS
CPT codes 43770-43774, 43886-43888, HCPCS code S2083, ICD-9 procedure codes 44.95, 44.97, 44.98 moved to covered 7/30/2010: Policy description updated to include detailed descriptions of gastric restrictive procedures and malabsorptive procedures. Policy statement section updated to include open or laparoscopic biliopa...
43770
PR LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE
HCPCS
CPT codes 43770-43774, 43886-43888, HCPCS code S2083, ICD-9 procedure codes 44.95, 44.97, 44.98 moved to covered 7/30/2010: Policy description updated to include detailed descriptions of gastric restrictive procedures and malabsorptive procedures. Policy statement section updated to include open or laparoscopic biliopa...
43886
Revise gastric port open
HCPCS
CPT codes 43770-43774, 43886-43888, HCPCS code S2083, ICD-9 procedure codes 44.95, 44.97, 44.98 moved to covered 7/30/2010: Policy description updated to include detailed descriptions of gastric restrictive procedures and malabsorptive procedures. Policy statement section updated to include open or laparoscopic biliopa...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
FEP prior authorization requirement and FDA language added to policy exception section. Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to c...
S9452
Nutrition class
HCPCS
FEP prior authorization requirement and FDA language added to policy exception section. Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to c...
43659
HC UNLISTED LAPAROSCOPE PROC STOM
HCPCS
FEP prior authorization requirement and FDA language added to policy exception section. Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to c...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
FEP prior authorization requirement and FDA language added to policy exception section. Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to c...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added ...
S9452
Nutrition class
HCPCS
Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added ...
43659
HC UNLISTED LAPAROSCOPE PROC STOM
HCPCS
Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added ...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added ...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to th...
S9452
Nutrition class
HCPCS
Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to th...
43659
HC UNLISTED LAPAROSCOPE PROC STOM
HCPCS
Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to th...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to th...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to the Covered Codes table. 08/19/2011: Policy statement revised to state that the patie...
S9452
Nutrition class
HCPCS
CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to the Covered Codes table. 08/19/2011: Policy statement revised to state that the patie...
G6015
Radiation tx delivery imrt
HCPCS
Policy description and statement updated to change "radiation therapy" to "radiotherapy." Added policy statement: Intensity-modulated radiotherapy (IMRT) is considered not medically necessary for the treatment of tumors of the CNS for all indications not meeting the criteria above. 12/31/2014: Added the following new 2...
77386
HC IMRT COMPLEX
HCPCS
Policy description and statement updated to change "radiation therapy" to "radiotherapy." Added policy statement: Intensity-modulated radiotherapy (IMRT) is considered not medically necessary for the treatment of tumors of the CNS for all indications not meeting the criteria above. 12/31/2014: Added the following new 2...
77385
HC IMRT SIMPLE
HCPCS
Policy description and statement updated to change "radiation therapy" to "radiotherapy." Added policy statement: Intensity-modulated radiotherapy (IMRT) is considered not medically necessary for the treatment of tumors of the CNS for all indications not meeting the criteria above. 12/31/2014: Added the following new 2...
G6016
PR DELIVERY COMP IMRT
HCPCS
Policy description and statement updated to change "radiation therapy" to "radiotherapy." Added policy statement: Intensity-modulated radiotherapy (IMRT) is considered not medically necessary for the treatment of tumors of the CNS for all indications not meeting the criteria above. 12/31/2014: Added the following new 2...
G6015
Radiation tx delivery imrt
HCPCS
Added policy statement: Intensity-modulated radiotherapy (IMRT) is considered not medically necessary for the treatment of tumors of the CNS for all indications not meeting the criteria above. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015...
77386
HC IMRT COMPLEX
HCPCS
Added policy statement: Intensity-modulated radiotherapy (IMRT) is considered not medically necessary for the treatment of tumors of the CNS for all indications not meeting the criteria above. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015...
77385
HC IMRT SIMPLE
HCPCS
Added policy statement: Intensity-modulated radiotherapy (IMRT) is considered not medically necessary for the treatment of tumors of the CNS for all indications not meeting the criteria above. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015...
G6016
PR DELIVERY COMP IMRT
HCPCS
Added policy statement: Intensity-modulated radiotherapy (IMRT) is considered not medically necessary for the treatment of tumors of the CNS for all indications not meeting the criteria above. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015...
G6015
Radiation tx delivery imrt
HCPCS
12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy reviewed; no change in policy statements. Policy Guidelin...
77386
HC IMRT COMPLEX
HCPCS
12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy reviewed; no change in policy statements. Policy Guidelin...
77385
HC IMRT SIMPLE
HCPCS
12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy reviewed; no change in policy statements. Policy Guidelin...
G6016
PR DELIVERY COMP IMRT
HCPCS
12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy reviewed; no change in policy statements. Policy Guidelin...
G6015
Radiation tx delivery imrt
HCPCS
Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy reviewed; no change in policy statements. Policy Guidelines section updated to add medically necessary and investigative definitions. SOURCE(S)Blue Cross Bl...
G6016
PR DELIVERY COMP IMRT
HCPCS
Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy reviewed; no change in policy statements. Policy Guidelines section updated to add medically necessary and investigative definitions. SOURCE(S)Blue Cross Bl...
20987
Cptr-asst dir ms px pre img
CPT
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m...
20986
Cptr-asst dir ms px io img
CPT
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m...
L8692
Non-osseointegrated snd proc
HCPCS
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m...
L8692
Non-osseointegrated snd proc
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
L8692
Non-osseointegrated snd proc
HCPCS
POLICY HISTORY8/24/2007: Policy added 9/19/2007: Code reference section updated. ICD-9 2007 revisions added to policy 11/15/2007: Policy approved by MPAC 10/7/2008: Policy reviewed, no changes 3/15/2010: Code Reference section updated. New HCPCS code L8692 added to covered table. 04/21/2010: Policy description updated ...
L8692
Non-osseointegrated snd proc
HCPCS
ICD-9 2007 revisions added to policy 11/15/2007: Policy approved by MPAC 10/7/2008: Policy reviewed, no changes 3/15/2010: Code Reference section updated. New HCPCS code L8692 added to covered table. 04/21/2010: Policy description updated regarding FDA approval of devices. The medically necessary policy statements were...
L8692
Non-osseointegrated snd proc
HCPCS
New HCPCS code L8692 added to covered table. 04/21/2010: Policy description updated regarding FDA approval of devices. The medically necessary policy statements were revised to add “5 years of age and older” to be consistent with FDA-approved labeling. “Sensorineural” added to the second statement. The intent of the po...
L8693
IMPL COCLR 4MM BAHA TI ABTMNT B1300
HCPCS
The intent of the policy statements unchanged. FEP verbiage added to the Policy Exceptions section. 03/09/2011: Added new HCPCS code L8693 to the Code Reference section. 04/25/2011: Audiologic criteria moved from the policy guidelines to the policy statement. 03/02/2012: Added policy statement to indicate that partiall...
L8693
IMPL COCLR 4MM BAHA TI ABTMNT B1300
HCPCS
FEP verbiage added to the Policy Exceptions section. 03/09/2011: Added new HCPCS code L8693 to the Code Reference section. 04/25/2011: Audiologic criteria moved from the policy guidelines to the policy statement. 03/02/2012: Added policy statement to indicate that partially implantable bone conduction hearing systems u...
L8693
IMPL COCLR 4MM BAHA TI ABTMNT B1300
HCPCS
03/09/2011: Added new HCPCS code L8693 to the Code Reference section. 04/25/2011: Audiologic criteria moved from the policy guidelines to the policy statement. 03/02/2012: Added policy statement to indicate that partially implantable bone conduction hearing systems using magnetic coupling for acoustic transmission are ...
G0358
IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
G0360
Each additional hr 1-8 hrs
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
J9000
INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
G0364
HC BONE MARROW ASPIRATE & BIOPSY
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
G0362
Each add sequential infusion
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
J9999
Not otherwise classified, antineoplastic drugs
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
G0359
Chemotherapy IV one hr initi
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
38230
PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
G0361
Prolong chemo infuse>8hrs pu
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
G0357
IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
G0356
HORMONAL ANTINEOPLASTIC
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
G0355
CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
G0358
IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0360
Each additional hr 1-8 hrs
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
J9000
INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0364
HC BONE MARROW ASPIRATE & BIOPSY
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0362
Each add sequential infusion
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
J9999
Not otherwise classified, antineoplastic drugs
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0359
Chemotherapy IV one hr initi
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
38230
PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0361
Prolong chemo infuse>8hrs pu
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0357
IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0356
HORMONAL ANTINEOPLASTIC
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0355
CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0358
IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0267
Bone marrow or psc harvest
CPT
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0360
Each additional hr 1-8 hrs
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
J9000
INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
S2140
Cord blood harvesting for transplantation, allogeneic
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0364
HC BONE MARROW ASPIRATE & BIOPSY
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0265
Cryopresevation Freeze+stora
CPT
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0362
Each add sequential infusion
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
J9999
Not otherwise classified, antineoplastic drugs
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0359
Chemotherapy IV one hr initi
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
38230
PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0361
Prolong chemo infuse>8hrs pu
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0357
IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0356
HORMONAL ANTINEOPLASTIC
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...