Policy Updates Medical Policy & Clinical GuidelinesCommercialApril 1, 2024

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements

Medical Policies and Clinical Guidelines updates — April 2024

The following Medical Polices and Clinical Guidelines for Anthem were reviewed for Indiana, Kentucky, Missouri, Ohio, and Wisconsin.

To view Medical Policies and Utilization Management Guidelines, go to anthem.com > Select Providers > Select your state > Under Provider Resources > Select Policies, Guidelines & Manuals.

To help determine if prior authorization is needed for Anthem members, go to anthem.com > Select Providers > Select your state > Under Claims > Select Prior Authorization. You can also call the prior authorization phone number on the back of the member’s ID card.

To view Medical Policies and Utilization Management Guidelines applicable to members enrolled in the Blue Cross and Blue Shield Service Benefit Plan (commonly referred to as the Federal Employee Program® (FEP®)), please visit fepblue.org > Policies & Guidelines.

Below are the new medical policies and/or clinical guidelines that have been approved.

*Denotes prior authorization required

Policy/guideline

Information

Effective date

MED.00146          Gene Therapy for Sickle Cell Disease

Outlines the MN and INV&NMN criteria for Gene therapy for sickle cell disease. No specific HCPCS codes for Casgevy & Lyfgenia, listed NOC codes C9399, J3490, J3590 and specific ICD-10-PCS XW133J8, XW143J8, XW133H9, XW143H9; considered MN when criteria are met.

7/1/2024

RAD.00068 Myocardial Strain Imaging

Myocardial strain imaging in considered INV&NMN for all indications. Added existing CPT® code 93356 (add-on ro echocardiography) and HCPCS outpatient codes C9762, C9763 associated with strain-encoded cardiac MRI, considered INV&NMN.

7/1/2024

Below are the current Clinical Guidelines and/or Medical Policies we reviewed, and updates were approved.

*Denotes prior authorization required

Policy/guideline

Information

Effective date

CG-GENE-13    Genetic Testing for Inherited Diseases

• Added additional genes to the table, including those identified as medically actionable by ACMG recommendations, drug-related genes for Leqembi (lecanemab-irmb) associated with Late Onset Alzheimer’s, and Rivfloza (Nedosiran) associated with Primary hyperoxaluria type 1

CPT Tier 2 code 81401 when specified as APOE gene testing and HCPCS code S3852 considered MN when criteria are met (was NMN); added CALM genes (NOC code 81479) considered MN when criteria are met; removed 81599 NOC (not applicable); updated CPT descriptors effective 1/1/2024

1/3/2024

ANC.00009    Cosmetic and Reconstructive Services of the Trunk, Groin, and Extremities

Revised MN criteria for lipectomy or liposuction for lymphedema and lipedema related to functional impairment or medical complications

• Revised Clinical Indications section with minor typographical updates

• Reformatted Clinical Indications section

No changes to coding

1/3/2024

CG-ANC-04 Ambulance Services: Air and Water

Revised Clinical Indications section regarding timeframe difference for ground and air transport

No changes to coding

1/3/2024

CG-DME-31    Powered Wheeled Mobility Devices

• Revised hierarchy and formatting in the Clinical Indications section

• Revised MN statement regarding Group 4 devices and MRADLs

• Revised MN criteria regarding trial period for motorized wheelchairs for children

• Revised NMN statement regarding repair or replacement

• Revised NMN statement regarding options/accessories/features for powered wheeled mobility devices

• Removed statement addressing home modifications

No changes to coding

11/16/2023

CG-DME-44      Electric Tumor Treatment Field (TTF)

• Removed criteria requiring treatment begin within 7 weeks of completion of temozolomide and radiotherapy

• Revised criteria to add definition of tumor progression to the Clinical Indications

• Reformatted criteria to limit criteria to one requirement per line

No changes to coding

1/3/2024

CG-GENE-14        Gene Mutation Testing for Cancer Susceptibility and Management

Listed additional ICD-10-CM diagnosis codes considered MN when criteria are met; added genes to Tier 2 and NOC code 81479

1/3/2024

CG-GENE-18    Genetic Testing for TP53 Mutations

Added personal or family history of pediatric hypodiploid acute lymphoblastic leukemia as a MN indication for germline testing

No changes to coding

1/3/2024

CG-SURG-83    Bariatric Surgery and Other Treatments for Clinically Severe Obesity

Added CPT Category III code 0813T effective 1/1/2024 for adjustment of intragastric balloon, considered NMN; also added CPT NOC code 44238

7/1/2024

CG-SURG-94 Keratoprosthesis

Reformatted MN section

• Revised MN criteria regarding number of previous failed corneal transplants

• Added new MN criteria for when corneal transplant is likely to fail

Added ICD-10-CM diagnosis codes for high risk for corneal transplant failure considered MN when criteria are met

1/3/2024

CG-SURG-95      Sacral Nerve Stimulation and Percutaneous or Implantable Tibial Nerve Stimulation for Urinary and Fecal Incontinence, Urinary Retention

• Revised formatting of Clinical Indications section

• Revised MN criteria for trial sacral nerve stimulators for urinary incontinence/urgency/frequency and retention to add new examples of conservative treatments

• Revised permanent sacral nerve stimulators MN criteria for urinary urgency/frequency

• Revised sacral nerve stimulation NMN statement

• Added new MN criteria for percutaneous and implantable tibial nerve stimulation

• Added new MN and NMN criteria for replacement or revision of percutaneous and Implantable tibial nerve stimulators

• Revised percutaneous and implantable tibial nerve stimulation NMN statement

Revised codes 0587T, 0588T, 64566 for tibial nerve stim considered MN when criteria are met (were NMN); removed CPT codes 0589T, 0590T for subsequent services; added CPT category III codes 0816T, 0817T, 0818T, 0819T effective 1/1/2024 for integrated TNS systems considered MN when criteria are met

7/1/2024

LAB.00019    Proprietary Algorithms for Liver Fibrosis

Previously titled: Proprietary Algorithms for Liver Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease

• Revised title

• Revised INV&NMN Position Statement

Added new CPT code 81517 effective 1/1/2024 for the ELF test considered INV&NMN, replacing deleted code 0014M

7/1/2024

LAB.00026      Systems Pathology and Multimodal Artificial Intelligence Testing for Prostate Cancer

Previously titled: Systems Pathology Testing for Prostate Cancer

• Revised title

• Added “Multimodal Artificial Intelligence” to the Position Statement

No changes to coding

1/3/2024

LAB.00046          Testing for Biochemical Markers for Alzheimer’s Disease

• Added MN criteria for measurement of amyloid beta

• Revised INV&NMN statement

CPT codes 83520 and 0358U will be considered MN for dementia diagnoses when criteria are met (was NMN)

1/3/2024

LAB.00050 Metagenomic Sequencing for Infectious Disease in the Outpatient Setting

• Moved content from GENE.00053

Added CPT PLA codes 0112U; 0152U; 0323U considered INV&NMN and NOC code 87999 previously addressed in GENE.00053

7/1/2024

MED.00057             MRI Guided High Intensity Focused Ultrasound Ablation for Non-Oncologic Indications

• Added MN criteria for Parkinson's Disease

CPT Category III code 0398T will be considered MN for Parkinson's diagnosis codes when criteria are met (was Inv&NMN)

1/3/2024

MED.00130        Surface Electromyography and Electrodermal Activity Sensor Devices for Seizure Monitoring

Added existing HCPCS code E0746 when specified as home biofeedback SPEAC device considered INV&NMN

7/1/2024

MED.00140          Gene Therapy for Beta Thalassemia

Previously titled: Lentiviral Gene Therapy for Beta Thalassemia and Sickle Cell Disease

• Revised title

• Revised MN statement

• Removed INV&NMN statement on lovotibeglogene

Autotemcel

Removed ICD-10-PCS codes XW133H9, XW143H9 specific to lovotibeglogene autotemcel, now addressed in MED.00146

1/18/2024

SURG.00010 Treatments for Urinary Incontinence

• Revised MN statements and changed to alphanumeric

• Revised Note

• Added NMN statement on periurethral bulking agents and revised existing NMN statement

• Removed line on periurethral bulking agents from INV&NMN statement and changed to alphanumeric

CPT code 51715 and associated ICD-10-PCS codes for bulking agents will be considered NMN when criteria are not met (was INV&NMN)

1/3/2024

SURG.00023      Breast Procedures; including Reconstructive Surgery, Implants and Other Breast Procedures

• Revised formatting of Position Statement

• Revised reconstructive statement related to procedures done in advance of mastectomy or lumpectomy

• Moved reconstructive text related to procedure timing to Background section

• Revised Position Statement section with text updates

No changes to coding

1/3/2024

SURG.00026        Deep Brain, Cortical, and Cerebellar Stimulation

• Reformatted Position Statement and added headers

• Reformatted MN statements to move target treatment areas into criteria

• Revised MN statement for primary dystonia to remove dystonia manifestation types

• Reformatted MN statements for DBS for Parkinson’s, primary dystonia, and OCD

• Reformatted MN statements for epilepsy

• Revised DBS for epilepsy MN statement regarding non-epileptic seizures

• Revised Position Statement to add revision/replacement MN and INV&NMN statements for DBS, cortical stimulation, and battery

• Revised and reformatted INV&NMN statements

Added existing ICD-10-PCS code 0NH00NZ and new CPT codes 61889, 61891 effective 1/1/2024 for skull-mounted systems, considered MN when criteria are met; also added existing HCPCS code C1778 device code considered MN when criteria are met

7/1/2024

SURG.00097  Scoliosis Surgery

• Revision to Position Statement formatting

• Added MN and INV&NMN criteria for revision, replacement, or removal of vertebral body tethering to Position Statement

Added CPT codes 22836, 22837, 22838 effective 1/1/2024 for thoracic tethering, and Category III code 0790T for thoracolumbar or lumbar tethering revision considered MN when criteria are met; also revised descriptors for 0656T, 0657T

7/1/2024

SURG.00142 Genicular Procedures for Treatment of Knee Pain

Previously titled: Genicular Nerve Blocks and Ablation for Chronic Knee Pain

• Revised title

• Added genicular artery embolization to the scope of document

• Revised Position Statement to add genicular artery embolization as INV&NMN

Added existing CPT code 37242 for arterial embolization, considered INV&NMN when specified as genicular artery embolization for knee pain

7/1/2024

SURG.00158 Implantable Peripheral Nerve Stimulation Devices as a Treatment for Pain

Added new CPT codes 64596, 64597 effective 1/1/2024 for integrated systems, updated descriptor for CPT code 64590

7/1/2024

TRANS.00013      Small Bowel, Small Bowel/Liver, and Multivisceral Transplantation

No changes to coding;

added diagnosis code examples K90.821-K90.829, K90.83 to document

1/3/2024

TRANS.00027 Hematopoietic Stem Cell Transplantation for Pediatric Solid Tumors

• Added definition of tandem to Position Statement

• Revised MN criteria for autologous hematopoietic stem cell transplantation for stage IVa and stage IVb retinoblastoma

• Revised INV&NMN statement for allogeneic (ablative or non-myeloablative [mini transplant]) for retinoblastoma

Autologous transplant codes will be considered MN for retinoblastoma diagnosis codes when criteria are met (was INV&NMN)

1/3/2024

DME.00011      Electrical Stimulation as a Treatment for Pain and Other Conditions: Surface and Percutaneous Devices

Added new HCPCS codes A4540, E0732 effective 1/1/2024 for cranial electrotherapy considered INV&NMN replacing deleted codes K1002, K1023; removed CPT Category III codes 0768T, 0769T deleted as of 1/1/2024; updated descriptors for 0766T, 0767T effective 1/1/2024

7/1/2024

DME.00042    Electronic Positional Devices for the Treatment of Obstructive Sleep Apnea

Added new HCPCS code E0530 effective 1/1/2024 considered INV&NMN, replacing deleted code K1001

7/1/2024

DME.00043 Neuromuscular Electrical Training for the Treatment of Obstructive Sleep Apnea or Snoring

Added new HCPCS codes E0492, E0493 effective 1/1/2024 for the Snoozeal device using phone application considered INV&NMN, replacing deleted codes K1028, K1029

7/1/2024

DME.00046 Intermittent Abdominal Pressure Ventilation Devices

Added new HCPCS code A4468 effective 1/1/2024 for exsufflation belt considered INV&NMN, replacing deleted code K1021

7/1/2024

DME.00049      External Upper Limb Stimulation for the Treatment of Tremors

Added new HCPCS codes A4542, E0734 effective 1/1/2024 for the Cala Trio and Cala kIQ devices considered INV&NMN; replacing deleted codes K1018, K1019

7/1/2024

GENE.00010        Panel and other Multi-Gene Testing for Polymorphisms to Determine Drug-Metabolizer Status

Added new CPT PLA codes 0423U, 0434U, 0438U effective 1/1/2024 for Genomind, RightMed and EffectiveRx tests considered INV&NMN

7/1/2024

GENE.00052       Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling

Added new CPT gene panel codes 81457, 81458, 81459, 81462, 81463, 81464, 0428U considered MN when criteria are met, codes 0422U, 0424U, 0436U considered NMN, and 0425U, 0426U considered INV&NMN effective 1/1/2024; also revised descriptors for codes 81445, 81449, 81450, 81451, 81455, 81456, 0356U.

7/1/2024

GENE.00056        Gene Expression Profiling for Bladder Cancer

Added new CPT PLA code 0420U effective 1/1/2024 for Cxbladder Detect+ test considered INV&NMN

7/1/2024

LAB.00003                  In Vitro Chemosensitivity Assays and In Vitro Chemoresistance Assays

Added new CPT PLA code 0435U effective 1/1/2024 for ChemoID test considered NMN

7/1/2024

LAB.00016            Fecal Analysis in the Diagnosis of Intestinal Disorders

Added new CPT PLA code 0430U effective 1/1/2024 for a malabsorption panel considered INV&NMN

7/1/2024

MED.00101 Physiologic Recording of Tremor using Accelerometer(s) and Gyroscope(s)

Removed CPT Category III codes 0533T-0536T deleted as of 1/1/2024, replaced by 95999 NOC already on document

12/28/2023

MED.00120          Gene Therapy for Ocular Conditions

Added existing CPT Category III code 0810T for subretinal injection considered MN when criteria are met; removed HCPCS code C9770 for subretinal injection deleted as of 1/1/2024

7/1/2024

MED.00135          Gene Therapy for Hemophilia

Added new HCPCS code J1412 effective 1/1/2024 for Roctavian considered MN when criteria are met, replacing NOC codes

7/1/2024

MED.00144          Gene Therapy for Duchenne Muscular Dystrophy

Added new HCPCS code J1413 effective 1/1/2024 for ELEVIDYS considered MN when criteria are met, replacing NOC codes for this product

7/1/2024

SURG.00007        Vagus Nerve Stimulation

Added new HCPCS code E0735 effective 1/1/2024 for non-invasive VNS device considered INV&NMN, replacing deleted code K1020

7/1/2024

SURG.00011 Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting

Added new HCPCS codes Q4279, Q4287, Q4288, Q4289, Q4291, Q4292, Q4293, Q4294, Q4295, Q4296, Q4297, Q4298, Q4299, Q4300, Q4301, Q4302, Q4303, Q4304 for products considered INV&NMN, added Q4290 considered MN for ocular indications, revised descriptor for Q4225 all effective 1/1/2024

7/1/2024

SURG.00037 Treatment of Varicose Veins (Lower Extremities)

No changes to coding

Added wording to clarify when codes 36465, 36466 may be MN based on criteria

1/3/2024

SURG.00045 Extracorporeal Shock Wave Therapy

Added new CPT Category III code 0864T effective 1/1/2024 for ESWT to corpus cavernosum considered INV&NMN, replacing NOC code 55899

7/1/2024

SURG.00077     Uterine Fibroid Ablation: Laparoscopic, Percutaneous or Transcervical Image Guided Techniques

Added new CPT code 58580 effective 1/1/2024 for transcervical RF ablation considered MN when criteria are met, replacing deleted code 0404T

7/1/2024

SURG.00150  Leadless Pacemaker

Added new CPT Category III codes 0823T, 0824T, 0825T, 0826T effective 1/1/2024 for leadless atrial pacemakers considered INV&NMN

7/1/2024

SURG.00152   Wireless Cardiac Resynchronization Therapy for Left Ventricular Pacing

Added new CPT Category III codes 0861T, 0862T, 0863T effective 1/1/2024 considered INV&NMN, also revised descriptors for 0517T, 0518T, 0519T, 0520T

7/1/2024

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

Added new CPT codes 31242, 31243 effectives 1/1/2024 for RF and cryoablation of posterior nasal nerve considered INV&NMN, replacing deleted HCPCS code C9771

7/1/2024

CG-OR-PR-08 Microprocessor Controlled Lower Limb Prosthesis

Added new HCPCS code L5615 for a lower extremity prosthesis addition considered MN when criteria are met, replacing deleted code K1014

7/1/2024

CG-SURG-81 Cochlear Implants and Auditory Brainstem Implants

Added ICD-10-CM diagnosis codes for hearing loss with unrestricted hearing in the contralateral ear considered MN for cochlear implants when criteria are met

12/28/2023

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PUBLICATIONS: April 2024 Provider Newsletter