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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...
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...
86816
HC HLA TYPING DR/DQ SINGLE AG
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...
38204
PR MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ
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...
86821
Lymphocyte culture mixed
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...
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...
86812
Immunologic analysis for autoimmune disease, A, B, or C, single antigen
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...
86822
Lymphocyte culture primed
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...
86817
HC HLA TYPING; DR/DQ, MULTIPLE ANTIGENS
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...
86813
HC HLA TYPING; A, B, OR C, MULTIPLE ANTIGENS
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. 3/25/2004: 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...
86816
HC HLA TYPING DR/DQ SINGLE AG
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: 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...
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. 3/25/2004: 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...
38204
PR MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: 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...
86821
Lymphocyte culture mixed
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: 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...
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. 3/25/2004: 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...
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. 3/25/2004: 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...
86812
Immunologic analysis for autoimmune disease, A, B, or C, single antigen
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: 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...
86822
Lymphocyte culture primed
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: 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...
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. 3/25/2004: 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...
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. 3/25/2004: 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...
86817
HC HLA TYPING; DR/DQ, MULTIPLE ANTIGENS
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: 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...
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. 3/25/2004: 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...
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. 3/25/2004: 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...
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. 3/25/2004: 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...
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. 3/25/2004: 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...
86813
HC HLA TYPING; A, B, OR C, MULTIPLE ANTIGENS
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: 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...
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. 3/25/2004: 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...
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. 3/25/2004: 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...
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. 3/25/2004: 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...
G0358
IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
86816
HC HLA TYPING DR/DQ SINGLE AG
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
G0360
Each additional hr 1-8 hrs
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
38204
PR MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
86821
Lymphocyte culture mixed
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
J9999
Not otherwise classified, antineoplastic drugs
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
G0361
Prolong chemo infuse>8hrs pu
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
86812
Immunologic analysis for autoimmune disease, A, B, or C, single antigen
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
86822
Lymphocyte culture primed
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
G0359
Chemotherapy IV one hr initi
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
38230
PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
86817
HC HLA TYPING; DR/DQ, MULTIPLE ANTIGENS
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
J9000
INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
G0364
HC BONE MARROW ASPIRATE & BIOPSY
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
G0362
Each add sequential infusion
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
86813
HC HLA TYPING; A, B, OR C, MULTIPLE ANTIGENS
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
G0357
IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
G0356
HORMONAL ANTINEOPLASTIC
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
G0355
CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC
HCPCS
3/25/2004: 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no...
86826
Hla x-match noncytotoxc addl
HCPCS
Policy description updated to include detailed description of Hematopoietic Stem Cell Transplantation (HSCT). Policy statement updated to include Single or Tandem autologous hematopoietic stem-cell transplant is considered not medically necessary to treat any stage of breast cancer. High Dose Chemotherapy language dele...
G0267
Bone marrow or psc harvest
CPT
Policy description updated to include detailed description of Hematopoietic Stem Cell Transplantation (HSCT). Policy statement updated to include Single or Tandem autologous hematopoietic stem-cell transplant is considered not medically necessary to treat any stage of breast cancer. High Dose Chemotherapy language dele...
G0265
Cryopresevation Freeze+stora
CPT
Policy description updated to include detailed description of Hematopoietic Stem Cell Transplantation (HSCT). Policy statement updated to include Single or Tandem autologous hematopoietic stem-cell transplant is considered not medically necessary to treat any stage of breast cancer. High Dose Chemotherapy language dele...
G0266
Thawing + expansion froz cel
CPT
Policy description updated to include detailed description of Hematopoietic Stem Cell Transplantation (HSCT). Policy statement updated to include Single or Tandem autologous hematopoietic stem-cell transplant is considered not medically necessary to treat any stage of breast cancer. High Dose Chemotherapy language dele...
86825
X-MATCHAHG
HCPCS
Policy description updated to include detailed description of Hematopoietic Stem Cell Transplantation (HSCT). Policy statement updated to include Single or Tandem autologous hematopoietic stem-cell transplant is considered not medically necessary to treat any stage of breast cancer. High Dose Chemotherapy language dele...
86826
Hla x-match noncytotoxc addl
HCPCS
Policy statement updated to include Single or Tandem autologous hematopoietic stem-cell transplant is considered not medically necessary to treat any stage of breast cancer. High Dose Chemotherapy language deleted from policy statement section. CPT code reference section update: New CPT codes 86825 and 86826 added to n...
G0267
Bone marrow or psc harvest
CPT
Policy statement updated to include Single or Tandem autologous hematopoietic stem-cell transplant is considered not medically necessary to treat any stage of breast cancer. High Dose Chemotherapy language deleted from policy statement section. CPT code reference section update: New CPT codes 86825 and 86826 added to n...
G0265
Cryopresevation Freeze+stora
CPT
Policy statement updated to include Single or Tandem autologous hematopoietic stem-cell transplant is considered not medically necessary to treat any stage of breast cancer. High Dose Chemotherapy language deleted from policy statement section. CPT code reference section update: New CPT codes 86825 and 86826 added to n...
G0266
Thawing + expansion froz cel
CPT
Policy statement updated to include Single or Tandem autologous hematopoietic stem-cell transplant is considered not medically necessary to treat any stage of breast cancer. High Dose Chemotherapy language deleted from policy statement section. CPT code reference section update: New CPT codes 86825 and 86826 added to n...
86825
X-MATCHAHG
HCPCS
Policy statement updated to include Single or Tandem autologous hematopoietic stem-cell transplant is considered not medically necessary to treat any stage of breast cancer. High Dose Chemotherapy language deleted from policy statement section. CPT code reference section update: New CPT codes 86825 and 86826 added to n...
86826
Hla x-match noncytotoxc addl
HCPCS
High Dose Chemotherapy language deleted from policy statement section. CPT code reference section update: New CPT codes 86825 and 86826 added to noncovered table. HCPCS codes G0265, G0266 and G0267 deleted from non-covered table due to these codes were deleted codes as of 12-31-2007. 04/19/2011: Policy reviewed; no cha...
G0267
Bone marrow or psc harvest
CPT
High Dose Chemotherapy language deleted from policy statement section. CPT code reference section update: New CPT codes 86825 and 86826 added to noncovered table. HCPCS codes G0265, G0266 and G0267 deleted from non-covered table due to these codes were deleted codes as of 12-31-2007. 04/19/2011: Policy reviewed; no cha...
G0265
Cryopresevation Freeze+stora
CPT
High Dose Chemotherapy language deleted from policy statement section. CPT code reference section update: New CPT codes 86825 and 86826 added to noncovered table. HCPCS codes G0265, G0266 and G0267 deleted from non-covered table due to these codes were deleted codes as of 12-31-2007. 04/19/2011: Policy reviewed; no cha...
G0266
Thawing + expansion froz cel
CPT
High Dose Chemotherapy language deleted from policy statement section. CPT code reference section update: New CPT codes 86825 and 86826 added to noncovered table. HCPCS codes G0265, G0266 and G0267 deleted from non-covered table due to these codes were deleted codes as of 12-31-2007. 04/19/2011: Policy reviewed; no cha...
86825
X-MATCHAHG
HCPCS
High Dose Chemotherapy language deleted from policy statement section. CPT code reference section update: New CPT codes 86825 and 86826 added to noncovered table. HCPCS codes G0265, G0266 and G0267 deleted from non-covered table due to these codes were deleted codes as of 12-31-2007. 04/19/2011: Policy reviewed; no cha...
E0751
PULSE GENERATOR OR RECEIVER
CPT
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...
95972
PR ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG
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...
63690
-1
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...
1999
ANESTHESIOLOGY GROUP
CPT
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...
95970
PR ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING
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...
E0753
NEUROSTIMUL ELECTRODES/LEADS
CPT
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...
95971
PR ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG
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...
63685
PR INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ
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...
63691
-1
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...
E0754
PT PROGRAMMER W/IMPL PROG NEUROSTIM PULSE GEN
CPT
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...
E0752
IMPLANTABLE NEUROSTIMULATOR ELECTRODE EACH
CPT
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...
63660
Revise/Remove Neuroelectrode
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...
95973
Analyze neurostim complex
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...
E0751
PULSE GENERATOR OR RECEIVER
CPT
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1993: Approved by Medical Policy Advisory Committee (MPAC) 3/2001: Policy reviewed; Hyperlinks inserted under Policy, Managed Care Requirements deleted, Sources updated 2/15/2002: I...
95972
PR ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1993: Approved by Medical Policy Advisory Committee (MPAC) 3/2001: Policy reviewed; Hyperlinks inserted under Policy, Managed Care Requirements deleted, Sources updated 2/15/2002: I...
63690
-1
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1993: Approved by Medical Policy Advisory Committee (MPAC) 3/2001: Policy reviewed; Hyperlinks inserted under Policy, Managed Care Requirements deleted, Sources updated 2/15/2002: I...
1999
ANESTHESIOLOGY GROUP
CPT
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1993: Approved by Medical Policy Advisory Committee (MPAC) 3/2001: Policy reviewed; Hyperlinks inserted under Policy, Managed Care Requirements deleted, Sources updated 2/15/2002: I...
95970
PR ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1993: Approved by Medical Policy Advisory Committee (MPAC) 3/2001: Policy reviewed; Hyperlinks inserted under Policy, Managed Care Requirements deleted, Sources updated 2/15/2002: I...
E0753
NEUROSTIMUL ELECTRODES/LEADS
CPT
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1993: Approved by Medical Policy Advisory Committee (MPAC) 3/2001: Policy reviewed; Hyperlinks inserted under Policy, Managed Care Requirements deleted, Sources updated 2/15/2002: I...
95971
PR ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1993: Approved by Medical Policy Advisory Committee (MPAC) 3/2001: Policy reviewed; Hyperlinks inserted under Policy, Managed Care Requirements deleted, Sources updated 2/15/2002: I...
63685
PR INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1993: Approved by Medical Policy Advisory Committee (MPAC) 3/2001: Policy reviewed; Hyperlinks inserted under Policy, Managed Care Requirements deleted, Sources updated 2/15/2002: I...
63691
-1
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1993: Approved by Medical Policy Advisory Committee (MPAC) 3/2001: Policy reviewed; Hyperlinks inserted under Policy, Managed Care Requirements deleted, Sources updated 2/15/2002: I...