Policy Updates November 2014

The information outlines updates to policies that are effective this month. To view the updated policy in its entirety, select the policy name.

Policy Name Affected Physicians Updates Effective Date
Pharmacy and Infusion Services Reimbursement Policy (R14)*
  • Oncology/Hematology
  • Infectious Disease
  • Rheumatology
  • Home Health Care Agencies
Claims submitted for infusion supplies and equipment billed separately and in addition to the infusion service codes will be administratively denied as duplicative and not eligible for separate reimbursement.
Affected CPT® codes are 96360-96549, and are limited to those when submitted on a HCFA 1500.

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The appearance of an item or procedure in this update indicates only that we have recently adopted or revised a policy. It does not imply that we provide coverage for the items or procedures listed. In the event of an inconsistency or conflict between the information provided below and the posted policy, the provisions of the posted policy will prevail.