Medical policy and clinical guideline updates - November 2020

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Information

Effective date

MED.00134 Non-invasive Heart Failure and Arrhythmia Management and Monitoring System

• The use of a non-invasive heart failure and arrhythmia management and monitoring system (for example, µ-Cor™ Heart Failure and Arrhythmia Management System) is considered Investigational and Not Medically Necessary (INV&NMN) for all indications.

- Existing codes 0607T, 0608T (which were effective 07/01/2020) will be considered INV&NMN for all indications

2/1/2021

SURG.00156 Implanted Artificial Iris Devices

• The use of implanted artificial iris devices is considered INV&NMN for all indications, including as a treatment of congenital or traumatic aniridia

-Existing codes 0616T, 0617T, 0618T (effective 07/01/20), C1839, 08RC3JZ, and 08RD3JZ will be considered INV&NMN for all indications

2/1/2021

*SURG.00157 Minimally Invasive Treatment of the Posterior Nasal Nerve to Treat Rhinitis

• Minimally invasive treatment of the posterior nasal nerve area, such as cryotherapy or radiofrequency therapy, to decrease the symptoms of allergic or nonallergic rhinitis is considered INV&NMN in all cases

- No specific code for cryotherapy or RF treatment of nasal tissue for rhinitis; listed 30999 (NOC) and 30117 if billed for this diagnosis, considered INV&NMN

2/1/2021

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Information

Effective date

* CG-SURG-104 Intraoperative Neurophysiological Monitoring

This Clinical Guideline addresses the various types of evoked response studies and their use in intraoperative neurophysiological monitoring when the monitoring is not provided by a member of the operating team. The use of neural evoked response studies for purposes other than assistance during a surgical procedure is not addressed in this document.

Applicable Codes:

- CPT codes: 95829, 95940, 95941

- HCPCS:  G0453

- ICD10 procedure codes: 4A1004G-4A10X4G, 4A1104G-4A11X4G

2/1/2021