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Notification of Medicare Medical Policy Review December 2023
Medical Policy Name | Summary of Changes |
|---|---|
| Durable Medical Equipment | Annual Review Medicare National Coverage Determinations Manual Chp 1 part 4, sec 280 Medicare Benefit Manual Chp 15 sec 110 Medicare Claims Processing Manual Chp 20 MLN SE1103 BCBSNC Evidence of Coverage Chp 4 No CMS Updates; Minor Revisions only |
| Foresee Home AMD Monitoring (PDF) | Annual Review: Sent to external physician for review https://www.accessdata.fda.gov/cdrh_docs/pdf9/K091579.pdf MEDCAC Meeting - Age-related Macular Degeneration (11/29/2005) (cms.gov) External Physician Reviewed and did not recommend any changes; Minor Revisions only |
| Investigational (Experimental) Services | Annual Review Medicare Claims Manual Chp 32 sec 68 & 69 Blue Medicare EOC Chp 4 sec 3.1 BCBSNC MCP: Investigational (Experimental) Services Medicare Managed Care Manual Chp 4 sec 10.7.2 & 90.5 CMS Manual System 100-02 Transmittal 198 MLN Matters MM8921 Medicare Benefit Manual Chp 14 sec 20 No CMS Updates. Minor Revisions only |
| Mitral Valve Transcatheter Edge to Edge Repair (PDF) | Annual Review Final Decision Memorandum for Transcatheter Mitral Valve Repair (TMVR) (CAG-00438R) No CMS Updates; Minor Revisions only |
| Refractive Surgical Procedures (PDF) | Annual Review NCD 80.7 American Academy of Ophthalmology Refractive Errors and Refractive Surgery Preferred Practice Pattern 2017 External Physician Reviewed: did not recommend any changes; Minor Revisions only; Removed 65765 epikeratophakia under applicable codes; Updated reference #2 to reflect updated link |
| Rehabilitation Therapy | Annual Review Medicare Benefit Policy Manual Chp 1 sec 110 No CMS Updates. Minor Revisions only Added the following statement to the beginning of policy: “This policy was implemented in the absence of National Coverage Determinations (NCD) or Local Coverage Determinations (LCD) coverage criteria.” Statement added to align with the 2024 CMS Final Rule. |
| Temporomandibular Joint Surgery (PDF) | Annual Review BCBSNC Corporate Medical Policy “Temporomandibular Joint Dysfunction (TMJD) Treatment” No CMS Updates. Minor Revisions only |
| Upper Limb Prosthetics (PDF) | Annual Review BCBSNC Corporate Medical Policy “Myoelectric Prosthetic Components for the Upper Limb” No CMS Updates. Additional reference added. Four (4) CPT codes added |
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