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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...
A4639
Replacement pad for infrared heating pad system, each
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...
1999
ANESTHESIOLOGY GROUP
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...
E0692
Uvl sys panel 4 ft
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...
97028
Ultraviolet therapy
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...
S9098
Home phototherapy visit
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...
E0202
Phototherapy light w/ photom
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...
A4634
Replacement bulb th lightbox
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...
E0694
Uvl md cabinet sys 6 ft
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...
E0691
Uvl pnl 2 sq ft or less
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...
A4633
Uvl replacement bulb
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...
E0690
UV CABINET APPROPRIATE HOME USE
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...
E0693
Uvl sys panel 6 ft
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...
A4639
Replacement pad for infrared heating pad system, each
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...
E0692
Uvl sys panel 4 ft
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...
97028
Ultraviolet therapy
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...
S9098
Home phototherapy visit
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...
E0202
Phototherapy light w/ photom
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...
A4634
Replacement bulb th lightbox
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...
E0694
Uvl md cabinet sys 6 ft
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...
E0691
Uvl pnl 2 sq ft or less
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...
A4633
Uvl replacement bulb
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...
E0690
UV CABINET APPROPRIATE HOME USE
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...
E0693
Uvl sys panel 6 ft
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...
A4639
Replacement pad for infrared heating pad system, each
HCPCS
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
1999
ANESTHESIOLOGY GROUP
CPT
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
E0692
Uvl sys panel 4 ft
HCPCS
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
97028
Ultraviolet therapy
HCPCS
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
S9098
Home phototherapy visit
HCPCS
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
E0202
Phototherapy light w/ photom
HCPCS
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
A4634
Replacement bulb th lightbox
HCPCS
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
E0694
Uvl md cabinet sys 6 ft
HCPCS
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
E0691
Uvl pnl 2 sq ft or less
HCPCS
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
A4633
Uvl replacement bulb
HCPCS
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
E0690
UV CABINET APPROPRIATE HOME USE
CPT
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
E0693
Uvl sys panel 6 ft
HCPCS
POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC) 4/1997: Investigational indication of seasonal affective disorder approved by (MPAC) 8/1999: Revisions approved by MPAC 2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added 5/2/2002: Type of Service...
88384
Eval molecular probes 11-50
CPT
Neither CancerType ID® nor miRview® (or Rosetta Cancer Origin™) have been submitted to FDA for approval. Gene expression profiling is considered investigational to evaluate the site of origin of a tumor of unknown primary, or to distinguish a primary from a metastatic tumor. Effective in July 2013, there is a specific ...
88384
Eval molecular probes 11-50
CPT
Gene expression profiling is considered investigational to evaluate the site of origin of a tumor of unknown primary, or to distinguish a primary from a metastatic tumor. Effective in July 2013, there is a specific CPT coding for the Pathwork Tissue of Origin test: 81504 - Oncology (tissue of origin), microarray gene e...
81599
Unlisted multianalyte assay with algorithmic analysis
CPT
Gene expression profiling is considered investigational to evaluate the site of origin of a tumor of unknown primary, or to distinguish a primary from a metastatic tumor. Effective in July 2013, there is a specific CPT coding for the Pathwork Tissue of Origin test: 81504 - Oncology (tissue of origin), microarray gene e...
88384
Eval molecular probes 11-50
CPT
Effective in July 2013, there is a specific CPT coding for the Pathwork Tissue of Origin test: 81504 - Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores Prior to July 2013, the preparation ...
81599
Unlisted multianalyte assay with algorithmic analysis
CPT
Effective in July 2013, there is a specific CPT coding for the Pathwork Tissue of Origin test: 81504 - Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores Prior to July 2013, the preparation ...
81599
Unlisted multianalyte assay with algorithmic analysis
CPT
Prior to July 2013, Pathwork Diagnostics stated that they used 84999 (unlisted chemistry procedure). The other tests described below do not have specific CPT codes. If the test result is calculated using an algorithm and reported as a numeric score(s) or as a probability, the unlisted multianalyte assays with algorithm...
81599
Unlisted multianalyte assay with algorithmic analysis
CPT
The other tests described below do not have specific CPT codes. If the test result is calculated using an algorithm and reported as a numeric score(s) or as a probability, the unlisted multianalyte assays with algorithmic analyses code 81599 would be reported. If not, the unlisted molecular pathology code 81479 would b...
90850
nan
CPT
Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. Sep 2011;22 Suppl 6:vi64-68. PMID 21908507 |CPT||81504||Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm re...
90850
nan
CPT
Ann Oncol. Sep 2011;22 Suppl 6:vi64-68. PMID 21908507 |CPT||81504||Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores| |ICD-9 Diagnosis||Investigational for all codes| |ICD-10-CM (effective ...
90850
nan
CPT
Sep 2011;22 Suppl 6:vi64-68. PMID 21908507 |CPT||81504||Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores| |ICD-9 Diagnosis||Investigational for all codes| |ICD-10-CM (effective 10/1/15)||I...
90850
nan
CPT
PMID 21908507 |CPT||81504||Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores| |ICD-9 Diagnosis||Investigational for all codes| |ICD-10-CM (effective 10/1/15)||Investigational for all releva...
95904
Sense nerve conduction test
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...
95903
Motor nerve conduction test
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...
95900
Motor nerve conduction test
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...
95904
Sense nerve conduction test
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 HISTORY3/2/2007: Policy added 3/22/2007: Reviewed and approved by Medical Policy Advisory Committee (MPAC) 6/14/2007: Code Reference section updated per quarterly HCPCS and Cat...
95903
Motor nerve conduction test
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 HISTORY3/2/2007: Policy added 3/22/2007: Reviewed and approved by Medical Policy Advisory Committee (MPAC) 6/14/2007: Code Reference section updated per quarterly HCPCS and Cat...
95900
Motor nerve conduction test
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 HISTORY3/2/2007: Policy added 3/22/2007: Reviewed and approved by Medical Policy Advisory Committee (MPAC) 6/14/2007: Code Reference section updated per quarterly HCPCS and Cat...
1999
ANESTHESIOLOGY GROUP
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...