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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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
86816
HC HLA TYPING DR/DQ SINGLE AG
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
38204
PR MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
86821
Lymphocyte culture mixed
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
86812
Immunologic analysis for autoimmune disease, A, B, or C, single antigen
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
86822
Lymphocyte culture primed
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
86817
HC HLA TYPING; DR/DQ, MULTIPLE ANTIGENS
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
86813
HC HLA TYPING; A, B, OR C, MULTIPLE ANTIGENS
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
G0355
CHEMO ADMN SUBQ/IM NONHORMONAL 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 # 8.01.35 per approval by Medical Policy Advisory Committee (MPAC) 6/25/2004: Code Reference section completed 11/18/2004: Review...
G0267
Bone marrow or psc harvest
CPT
9/18/2007: Policy reviewed, no changes 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions 1/06/2009: Policy reviewed. No changes. 10/6/2009: Code reference section updated. New ICD-9 diagnosis code 209.74 added to covered table. HCPC codes G0265, G0266 and G0267 deleted from covered table due to codes were deleted...
G0266
Thawing + expansion froz cel
CPT
9/18/2007: Policy reviewed, no changes 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions 1/06/2009: Policy reviewed. No changes. 10/6/2009: Code reference section updated. New ICD-9 diagnosis code 209.74 added to covered table. HCPC codes G0265, G0266 and G0267 deleted from covered table due to codes were deleted...
G0265
Cryopresevation Freeze+stora
CPT
9/18/2007: Policy reviewed, no changes 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions 1/06/2009: Policy reviewed. No changes. 10/6/2009: Code reference section updated. New ICD-9 diagnosis code 209.74 added to covered table. HCPC codes G0265, G0266 and G0267 deleted from covered table due to codes were deleted...
86826
Hla x-match noncytotoxc addl
HCPCS
Added Hematopoietic Stem-Cell Transplantation, Conventional Preparative Conditioning for Hematopietic Stem-Cell Transplantation, Reduced-Intensity Conditioning for Allogeneic SCT, SCT in Solid Tumors, and staging and therapy language for Germ-Cell Tumors. Policy Exceptions section was revised to include language about ...
38215
PR TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM
HCPCS
Added Hematopoietic Stem-Cell Transplantation, Conventional Preparative Conditioning for Hematopietic Stem-Cell Transplantation, Reduced-Intensity Conditioning for Allogeneic SCT, SCT in Solid Tumors, and staging and therapy language for Germ-Cell Tumors. Policy Exceptions section was revised to include language about ...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
Added Hematopoietic Stem-Cell Transplantation, Conventional Preparative Conditioning for Hematopietic Stem-Cell Transplantation, Reduced-Intensity Conditioning for Allogeneic SCT, SCT in Solid Tumors, and staging and therapy language for Germ-Cell Tumors. Policy Exceptions section was revised to include language about ...
S2140
Cord blood harvesting for transplantation, allogeneic
HCPCS
Added Hematopoietic Stem-Cell Transplantation, Conventional Preparative Conditioning for Hematopietic Stem-Cell Transplantation, Reduced-Intensity Conditioning for Allogeneic SCT, SCT in Solid Tumors, and staging and therapy language for Germ-Cell Tumors. Policy Exceptions section was revised to include language about ...
86825
X-MATCHAHG
HCPCS
Added Hematopoietic Stem-Cell Transplantation, Conventional Preparative Conditioning for Hematopietic Stem-Cell Transplantation, Reduced-Intensity Conditioning for Allogeneic SCT, SCT in Solid Tumors, and staging and therapy language for Germ-Cell Tumors. Policy Exceptions section was revised to include language about ...
38207
PR TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR
HCPCS
Added Hematopoietic Stem-Cell Transplantation, Conventional Preparative Conditioning for Hematopietic Stem-Cell Transplantation, Reduced-Intensity Conditioning for Allogeneic SCT, SCT in Solid Tumors, and staging and therapy language for Germ-Cell Tumors. Policy Exceptions section was revised to include language about ...
S2142
Cord blood-derived stem-cell transplantation, allogeneic
HCPCS
Added Hematopoietic Stem-Cell Transplantation, Conventional Preparative Conditioning for Hematopietic Stem-Cell Transplantation, Reduced-Intensity Conditioning for Allogeneic SCT, SCT in Solid Tumors, and staging and therapy language for Germ-Cell Tumors. Policy Exceptions section was revised to include language about ...
0279
Medical/Surgical Supplies and Devices (Also See 062x An Extension of 027x) - Other Supplies/Devices
RC
08/04/2014: Policy reviewed; description updated. Policy statement unchanged. Removed deleted CPT codes 0279T and 0280T from the Code Reference section. 07/13/2015: Code Reference section updated for ICD-10. SOURCE(S)Blue Cross Blue Shield Association policy # 2.04.37 CODE REFERENCEThis may not be a comprehensive list ...
0280
Oncology - General Classification
RC
08/04/2014: Policy reviewed; description updated. Policy statement unchanged. Removed deleted CPT codes 0279T and 0280T from the Code Reference section. 07/13/2015: Code Reference section updated for ICD-10. SOURCE(S)Blue Cross Blue Shield Association policy # 2.04.37 CODE REFERENCEThis may not be a comprehensive list ...
0279
Medical/Surgical Supplies and Devices (Also See 062x An Extension of 027x) - Other Supplies/Devices
RC
Policy statement unchanged. Removed deleted CPT codes 0279T and 0280T from the Code Reference section. 07/13/2015: Code Reference section updated for ICD-10. SOURCE(S)Blue Cross Blue Shield Association policy # 2.04.37 CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy.
0280
Oncology - General Classification
RC
Policy statement unchanged. Removed deleted CPT codes 0279T and 0280T from the Code Reference section. 07/13/2015: Code Reference section updated for ICD-10. SOURCE(S)Blue Cross Blue Shield Association policy # 2.04.37 CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy.
0279
Medical/Surgical Supplies and Devices (Also See 062x An Extension of 027x) - Other Supplies/Devices
RC
Removed deleted CPT codes 0279T and 0280T from the Code Reference section. 07/13/2015: Code Reference section updated for ICD-10. SOURCE(S)Blue Cross Blue Shield Association policy # 2.04.37 CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy.
0280
Oncology - General Classification
RC
Removed deleted CPT codes 0279T and 0280T from the Code Reference section. 07/13/2015: Code Reference section updated for ICD-10. SOURCE(S)Blue Cross Blue Shield Association policy # 2.04.37 CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy.
93762
Peripheral Thermogram
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
93760
Cephalic Thermogram
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
93799
HC UNLISTED CARDIOVASCULAR SERVICE/PROCEDURE
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
0049T
External circulation assist
CPT
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
33978
Remove ventricular device
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
33977
Remove ventricular device
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
0052T
Replace thrc unit hrt syst
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
33976
PR INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
33975
PR INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
0050T
Removal circulation assist
CPT
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
0053T
Replace implantable hrt syst
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
Q0480
Driver pneumatic vad, rep
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
0048T
Implant ventricular device
CPT
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
0051T
Implant total heart system
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a...
0049T
External circulation assist
CPT
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devic...
33978
Remove ventricular device
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 HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devic...
33977
Remove ventricular device
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 HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devic...
0052T
Replace thrc unit hrt syst
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 HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devic...
33976
PR INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR
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 HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devic...
33975
PR INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE
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 HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devic...
0050T
Removal circulation assist
CPT
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devic...
0053T
Replace implantable hrt syst
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 HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devic...
Q0480
Driver pneumatic vad, rep
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 HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devic...
0048T
Implant ventricular device
CPT
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devic...
0051T
Implant total heart system
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 HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devic...
0049T
External circulation assist
CPT
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational...
33978
Remove ventricular device
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational...
33977
Remove ventricular device
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational...
0052T
Replace thrc unit hrt syst
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational...
33976
PR INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational...
33975
PR INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational...
0050T
Removal circulation assist
CPT
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational...
0053T
Replace implantable hrt syst
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational...
Q0480
Driver pneumatic vad, rep
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational...
0048T
Implant ventricular device
CPT
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational...
0051T
Implant total heart system
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 2/14/2002: Investigational definition added 3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational...
0053T
Replace implantable hrt syst
HCPCS
Ventricular assist devices as destination therapy with end-stage heart failure changed from investigational to medically necessary for FDA-approved devices in patients ineligible for human heart transplant. Other policy statements revised for clarity; coverage remains the same. CPT codes 0051T-0053T moved to covered. I...
0051T
Implant total heart system
HCPCS
Ventricular assist devices as destination therapy with end-stage heart failure changed from investigational to medically necessary for FDA-approved devices in patients ineligible for human heart transplant. Other policy statements revised for clarity; coverage remains the same. CPT codes 0051T-0053T moved to covered. I...
Q4079
Natalizumab injection
HCPCS
Other policy statements revised for clarity; coverage remains the same. CPT codes 0051T-0053T moved to covered. ICD-9 procedure codes 37.52-37.54 moved to covered 9/22/2008: Annual ICD-9 updates effective 10-1-2008 applied 12/31/2008: Code Reference section updated per 2009 CPT/HCPCS revisions 8/19/2009: Policy reviewe...
0053T
Replace implantable hrt syst
HCPCS
Other policy statements revised for clarity; coverage remains the same. CPT codes 0051T-0053T moved to covered. ICD-9 procedure codes 37.52-37.54 moved to covered 9/22/2008: Annual ICD-9 updates effective 10-1-2008 applied 12/31/2008: Code Reference section updated per 2009 CPT/HCPCS revisions 8/19/2009: Policy reviewe...
0051T
Implant total heart system
HCPCS
Other policy statements revised for clarity; coverage remains the same. CPT codes 0051T-0053T moved to covered. ICD-9 procedure codes 37.52-37.54 moved to covered 9/22/2008: Annual ICD-9 updates effective 10-1-2008 applied 12/31/2008: Code Reference section updated per 2009 CPT/HCPCS revisions 8/19/2009: Policy reviewe...
Q4079
Natalizumab injection
HCPCS
ICD-9 procedure codes 37.52-37.54 moved to covered 9/22/2008: Annual ICD-9 updates effective 10-1-2008 applied 12/31/2008: Code Reference section updated per 2009 CPT/HCPCS revisions 8/19/2009: Policy reviewed, no changes 03/12/2010: Coding Section revised for 2010 CPT4 and HCPCS revision 12/30/2010: Policy description...
Q4079
Natalizumab injection
HCPCS
Policy statements revised to address only implantable VADs and total artificial hearts. 03/09/2011: Added new HCPCS codes Q4078 and Q4079 to the Code Reference section. 12/13/2011: Policy description and statement updated regarding percutaneous ventricular assist devices. Added the following policy statement: Percutane...
0048T
Implant ventricular device
CPT
Replaced "cleared devices" with "clearance." Added "Implantable" to the beggining of the policy statement under the Bridge to Transplantation section. Policy statement on implantable VADs as a bridge to heart tranplantation in children was revised to change the age range from "5 to 16" to "16 years old or younger," ref...
0050T
Removal circulation assist
CPT
Replaced "cleared devices" with "clearance." Added "Implantable" to the beggining of the policy statement under the Bridge to Transplantation section. Policy statement on implantable VADs as a bridge to heart tranplantation in children was revised to change the age range from "5 to 16" to "16 years old or younger," ref...
0048T
Implant ventricular device
CPT
Policy statement on implantable VADs as a bridge to heart tranplantation in children was revised to change the age range from "5 to 16" to "16 years old or younger," reflecting the approval of the BERLIN heart EXCOR device for pediatric patients. Policy guidelines updated to include coagulation disorders and inadequate...
0050T
Removal circulation assist
CPT
Policy statement on implantable VADs as a bridge to heart tranplantation in children was revised to change the age range from "5 to 16" to "16 years old or younger," reflecting the approval of the BERLIN heart EXCOR device for pediatric patients. Policy guidelines updated to include coagulation disorders and inadequate...
0048T
Implant ventricular device
CPT
Policy guidelines updated to include coagulation disorders and inadequate psychosocial support as contraindications for bridge to transplant VADs and TAH. Removed deleted CPT codes 0048T and 0050T from the Code Reference section. 07/07/2015: Code Reference section updated to add Investigational Codes table. CPT codes 3...
0050T
Removal circulation assist
CPT
Policy guidelines updated to include coagulation disorders and inadequate psychosocial support as contraindications for bridge to transplant VADs and TAH. Removed deleted CPT codes 0048T and 0050T from the Code Reference section. 07/07/2015: Code Reference section updated to add Investigational Codes table. CPT codes 3...
0048T
Implant ventricular device
CPT
Removed deleted CPT codes 0048T and 0050T from the Code Reference section. 07/07/2015: Code Reference section updated to add Investigational Codes table. CPT codes 33990, 33991, 33992, 33993 and ICD-9 procedure code 37.68 moved from Covered to Investigational. 08/27/2015: Code Reference section updated for ICD-10. Remo...
0050T
Removal circulation assist
CPT
Removed deleted CPT codes 0048T and 0050T from the Code Reference section. 07/07/2015: Code Reference section updated to add Investigational Codes table. CPT codes 33990, 33991, 33992, 33993 and ICD-9 procedure code 37.68 moved from Covered to Investigational. 08/27/2015: Code Reference section updated for ICD-10. Remo...
A4639
Replacement pad for infrared heating pad system, each
HCPCS
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
1999
ANESTHESIOLOGY GROUP
CPT
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
E0692
Uvl sys panel 4 ft
HCPCS
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
97028
Ultraviolet therapy
HCPCS
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
S9098
Home phototherapy visit
HCPCS
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
E0202
Phototherapy light w/ photom
HCPCS
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
A4634
Replacement bulb th lightbox
HCPCS
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
E0694
Uvl md cabinet sys 6 ft
HCPCS
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
E0691
Uvl pnl 2 sq ft or less
HCPCS
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
A4633
Uvl replacement bulb
HCPCS
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
E0690
UV CABINET APPROPRIATE HOME USE
CPT
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
E0693
Uvl sys panel 6 ft
HCPCS
Phototherapy (including light boxes, panels, or visors) is not covered for the following conditions because light therapy has not been shown to be more effective than placebo for: PUVA therapy is not covered when any of the following exists: Investigative service is defined as the use of any treatment procedure, facili...
A4639
Replacement pad for infrared heating pad system, each
HCPCS
Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances: The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Pol...