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22-077 Medical Policies - 4th Quarter 2021

Date: 02/04/22

This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary providers.

For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.

Review the latest changes to medical policies for procedures and services

The medical policies listed in this update were approved by Centene’s Corporate Clinical Policy Committee and/or Health Net’s Medical Advisory Council (MAC) in the fourth quarter of 2021. Visit our medical policies for a complete description of the background, criteria, references, and coding implications for the medical policies.

Purpose of medical policies

Medical policies offer guidelines to help determine medical necessity for certain procedures, equipment and services. They are not intended to give medical advice or tell providers how to practice. If required, providers must get prior authorization before services are given.

Medical policies vs member contract

All services must be medically needed, unless the member’s benefit plan coverage document states otherwise. This document defines member benefits in addition to eligibility requirements, and coverage exclusions and limits.

  • If legal or regulatory mandates apply, they may override medical policy.
  • If there are any conflicts between medical policy guidelines and related member benefits contract language, the benefits contract will apply.

For Medicare Advantage plans, apply the Medicare national and local policies for primary coverage guidance. For Medi-Cal plans, appropriate coverage guidelines take precedence over these plan policies and must be applied first.

For Cal MediConnect plans, Medicare and Medicaid national and local policies must be applied first for primary coverage guidance.

New Policies

Medical policy

Policy statement

CP.MP.209 – Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing

This policy addresses the medical necessity criteria for gastrointestinal pathogen nucleic acid detection panel testing.  

CP.MP.202

Orthognathic Surgery

This policy describes the medical necessity requirements for orthognathic surgery.

CP.MP.194

Osteogenic Stimulation

This policy outlines the medical necessity criteria for electrical and ultrasonic osteogenic stimulators to enhance the bone healing process.

 

Updated Policies

Policy number and name

Change

CP.MP. 158 –

Ambulatory Surgery Center Optimization

  • Removed pregnancy as a disqualifying condition.
  • Added to general guidelines, criteria for when non-obstetric surgery during pregnancy could be performed at an ambulatory surgery center (ASC). Minor rewording with no clinical significance.
  • Added CPT® codes 66982 and 66984 as appropriate for an ASC.

CP.MP. 164 – Caudal or Interlaminar Epidural Steroid Injections

Removed “Request is not for cervical interlaminar ESI above C7” from B.5, C.3 and D.5.

CP.MP. 53 – Ferriscan

Added I.H., “Hemodialysis for end stage renal failure” as an indication.

CP.MP.136 –

Home Birth

  • Added to I.A.2.b an option for family practice physicians who have completed an obstetrics fellowship to attend a home birth without a supervising obstetrician.
  • Removed WHO background information on home birth and supporting reference.

CP.MP.170 –

Nerve Blocks for Pain Management

Edited note in section VI to state: If administered as part of a surgery or other procedure, coding for peripheral/ganglion nerve blocks should follow proper coding practices and would not be subject to prior authorization or payment separately from the procedure.

CP.MP.190 –

Oxygen Use and Concentrators

  • Edited portable oxygen criteria to include option for “mobile within community” in addition to “within the home.”
  • Reorganized portable oxygen criteria within sections I and III.
  • Added criteria for portable oxygen systems for pediatrics in sections II and IV.
  • In the over 21 authorization and reauthorization sections regarding the qualifying blood gas study for portable oxygen and concentrators, removed “for the approved stationary concentrator” for clarity.

CP.MP.51 –

Reduction Mammoplasty & Gynecomastia Surgery

  • In I.A.2., changed “No change in cup size for at least 6 months” to “For adolescents, no breast growth equivalent to a change in cup size for at least 6 months.”
  • Updated background regarding gigantomastia of pregnancy with no impact on criteria.

CP.MP.151 –

Transcatheter Closure of Patent Foramen Ovale

 

  • Reworded policy statement, adding “when used according to FDA labeled indications, contraindications, warnings and precautions. 
  • Removed contraindications (I.B.4) since they are specific to the AmplatzerTM PFO device.
  • Updated background with 2021 American Heart Association (AHA)/American Stroke Association (ASA) recommendations.
  • Added American Academy of Neurology (AAN) recommendation for patients who opt to receive medical therapy alone without PFO closure.

CP.MP.152 –

Vitamin D, Measurement of Serum

  • Expanded ICD-10 code range for tuberculosis from A15.0–A15.5 to A15.0–A19.9.
  • Added N25.81 as a code supporting coverage criteria.

 

Clinical Practice Guidelines

Clinical Practice Guidelines Grid

  • Removed American Pain Society reference under back pain guidelines.
  • Added North American Spine Society (NASS) guideline for Diagnosis and Treatment of Low Back Pain (2020).
  • Removed the American Cancer Society Guidelines for the Early Detection of Cancer.

Inactive Policies

The following policies have been retired.

Policy number

Policy name

CP.MP.119

Balloon Sinus Ostial Dilation

HNCA.CP.MP.283

Neovascular Macular Degeneration

CP.MP.84

Cell-free Fetal DNA Testing

CP.MP.125

DNA Analysis of Stool

CP.MP.103

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Additional information

If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center within 60 days, by phone or through the Health Net provider website as listed below.

Line of Business

Telephone Number

Provider Portal

Email Address

EnhancedCare PPO (IFP)

1-844-463-8188


provider.healthnetcalifornia.com

provider_services@healthnet.com

EnhancedCare PPO (SBG)

1-844-463-8188


provider.healthnetcalifornia.com

provider_services@healthnet.com

Health Net Employer Group HMO, POS, HSP, PPO, & EPO

1-800-641-7761


provider.healthnetcalifornia.com

provider_services@healthnet.com

IFP (CommunityCare HMO, PPO, PureCare HSP, PureCare One EPO)

1-888-926-2164


provider.healthnetcalifornia.com

provider_services@healthnet.com

Medicare (individual)

1-800-929-9224


provider.healthnetcalifornia.com

provider_services@healthnet.com

Medicare Advantage (HMO/PPO)

(Wellcare By Health Net)

1-800-929-9224


provider.healthnetcalifornia.com

provider_services@healthnet.com

Medi-Cal

1-800-675-6110


provider.healthnetcalifornia.com

N/A

Cal MediConnect – Los Angeles County

1-855-464-3571

N/A

provider_services@healthnet.com

Cal MediConnect – San Diego County

1-855-464-3572

N/A



Last Updated: 02/04/2022