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Commercial Medical Policy Update for April 17, 2024
| Medical Guidelines | Reason for Update |
|---|---|
| Biochemical Markers of Alzheimer Disease and Dementia AHS – G2048 | CPT codes 0443U and 0445U added to Billing/Coding section, effective 4/1/24. |
| Biomarker Testing for Autoimmune Rheumatic Disease AHS – G2022 | Updated Billing/Coding section to add 0446U and 0447U, effective 4/1/2024. |
| Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases AHS – G2123 | CPT code 0443U added to the Billing/Coding Section, effective 4/1/24. |
| Genetic Markers for Assessing Risk of Cardiovascular Disease AHS – M2180 | Codes 0439U and 0440U added to Billing/Coding section, effective 4/1/24. |
| Laboratory Procedures Medical Policy AHS - R2162 | Code 0449U added to Billing/Coding section, effective 4/1/24. |
| Pathogen Panel Testing AHS – G2149 | Codes 0441U and 0442U added to Billing/Coding section, effective 4/1/24. |
| Perirectal Spacer Use During Radiotherapy for Prostate Cancer | Off cycle review to add not medically necessary statement for proton beam therapy. Under “when not covered” section added: “Transperineal placement of a biodegradable, perirectal spacer (ie SpaceOAR) is considered not medically necessary in individuals undergoing proton beam therapy for treatment of prostate cancer.” References added. Medical Director review 1/2024. Notification given 2/6/24 for effective date 4/17/24. |
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