code
stringlengths 4
12
| description
stringlengths 2
264
| codetype
stringclasses 8
values | context
stringlengths 160
15.5k
|
|---|---|---|---|
0801
|
Inpatient Renal Dialysis - Inpatient Hemodialysis
|
RC
|
The Regional Committee for Europe adopted the JMF in September 2018. The majority of JMF indicators in the Gateway are linked to existing databases in the Gateway. EUR/RC68/10 Rev.1 Briefing note on the expert group deliberations and recommended common set of indicators for a joint monitoring framework
EUR/RC68(1): Joint monitoring framework in the context of the roadmap to implement the 2030 Agenda for Sustainable Development, building on Health 2020, the European policy for health and well-being
Developing a common set of indicators for the joint monitoring framework for SDGs, Health 2020 and the Global NCD Action Plan (2017)
Indicator code: E080109.F This indicator shares the definition with the parent indicator \"\". A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes (see ICD-10 manual, vol. 2).
|
0109
|
Med-Surg
|
RC
|
The majority of JMF indicators in the Gateway are linked to existing databases in the Gateway. EUR/RC68/10 Rev.1 Briefing note on the expert group deliberations and recommended common set of indicators for a joint monitoring framework
EUR/RC68(1): Joint monitoring framework in the context of the roadmap to implement the 2030 Agenda for Sustainable Development, building on Health 2020, the European policy for health and well-being
Developing a common set of indicators for the joint monitoring framework for SDGs, Health 2020 and the Global NCD Action Plan (2017)
Indicator code: E080109.F This indicator shares the definition with the parent indicator \"\". A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes (see ICD-10 manual, vol. 2). Normally, maternal mortality cases are reported to WHO as a part of general mortality data by cause, sex and age.
|
0801
|
Inpatient Renal Dialysis - Inpatient Hemodialysis
|
RC
|
The majority of JMF indicators in the Gateway are linked to existing databases in the Gateway. EUR/RC68/10 Rev.1 Briefing note on the expert group deliberations and recommended common set of indicators for a joint monitoring framework
EUR/RC68(1): Joint monitoring framework in the context of the roadmap to implement the 2030 Agenda for Sustainable Development, building on Health 2020, the European policy for health and well-being
Developing a common set of indicators for the joint monitoring framework for SDGs, Health 2020 and the Global NCD Action Plan (2017)
Indicator code: E080109.F This indicator shares the definition with the parent indicator \"\". A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes (see ICD-10 manual, vol. 2). Normally, maternal mortality cases are reported to WHO as a part of general mortality data by cause, sex and age.
|
0109
|
Med-Surg
|
RC
|
EUR/RC68/10 Rev.1 Briefing note on the expert group deliberations and recommended common set of indicators for a joint monitoring framework
EUR/RC68(1): Joint monitoring framework in the context of the roadmap to implement the 2030 Agenda for Sustainable Development, building on Health 2020, the European policy for health and well-being
Developing a common set of indicators for the joint monitoring framework for SDGs, Health 2020 and the Global NCD Action Plan (2017)
Indicator code: E080109.F This indicator shares the definition with the parent indicator \"\". A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes (see ICD-10 manual, vol. 2). Normally, maternal mortality cases are reported to WHO as a part of general mortality data by cause, sex and age. However, in some countries due to the national death certification practices, the number of maternal deaths reported in this way is significantly lower (i.e.
|
0801
|
Inpatient Renal Dialysis - Inpatient Hemodialysis
|
RC
|
EUR/RC68/10 Rev.1 Briefing note on the expert group deliberations and recommended common set of indicators for a joint monitoring framework
EUR/RC68(1): Joint monitoring framework in the context of the roadmap to implement the 2030 Agenda for Sustainable Development, building on Health 2020, the European policy for health and well-being
Developing a common set of indicators for the joint monitoring framework for SDGs, Health 2020 and the Global NCD Action Plan (2017)
Indicator code: E080109.F This indicator shares the definition with the parent indicator \"\". A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes (see ICD-10 manual, vol. 2). Normally, maternal mortality cases are reported to WHO as a part of general mortality data by cause, sex and age. However, in some countries due to the national death certification practices, the number of maternal deaths reported in this way is significantly lower (i.e.
|
00100
|
ANESTH SALIVARY GLAND
|
CPT
|
The more than 7,000 five-character CPT Codes are an important part of the billing process. They are used by insurers to aid in determining the amount of reimbursement the physician or healthcare provider will receive for services rendered. - CPT Codes are copyrighted and maintained by the American Medical Association (AMA). Updated annually, these codes fall into three major categories. - Category I– The code range is 00100 to 99499.
|
00100
|
ANESTH SALIVARY GLAND
|
CPT
|
- CPT Codes are copyrighted and maintained by the American Medical Association (AMA). Updated annually, these codes fall into three major categories. - Category I– The code range is 00100 to 99499. Each five-digit code has a corresponding description of the procedure or service. - Category II – These are more of alphanumeric tracking codes to describe clinical components in-clinic services or evaluation and management.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
CPT Code Categories
* A medical coder is expected to know this information to be able to find the best possible code for the service or procedure. Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
Evaluation and Management (99201-99499) – which includes hospital observation services, office, and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, intrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more.
|
00100
|
ANESTH SALIVARY GLAND
|
CPT
|
CPT Code Categories
* A medical coder is expected to know this information to be able to find the best possible code for the service or procedure. Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
Evaluation and Management (99201-99499) – which includes hospital observation services, office, and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, intrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more.
|
01999
|
Unlisted anesth procedure
|
CPT
|
CPT Code Categories
* A medical coder is expected to know this information to be able to find the best possible code for the service or procedure. Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
Evaluation and Management (99201-99499) – which includes hospital observation services, office, and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, intrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
Evaluation and Management (99201-99499) – which includes hospital observation services, office, and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, intrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few.
|
00100
|
ANESTH SALIVARY GLAND
|
CPT
|
Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
Evaluation and Management (99201-99499) – which includes hospital observation services, office, and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, intrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few.
|
10000
|
Incision & drainage of sebaceous cyst-one
|
CPT
|
Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
Evaluation and Management (99201-99499) – which includes hospital observation services, office, and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, intrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few.
|
01999
|
Unlisted anesth procedure
|
CPT
|
Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
Evaluation and Management (99201-99499) – which includes hospital observation services, office, and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, intrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
Evaluation and Management (99201-99499) – which includes hospital observation services, office, and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, intrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. Radiology (70000-79999) –including ultrasound, mammography, bone/joint, oncology, and nuclear medicine.
|
00100
|
ANESTH SALIVARY GLAND
|
CPT
|
This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
Evaluation and Management (99201-99499) – which includes hospital observation services, office, and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, intrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. Radiology (70000-79999) –including ultrasound, mammography, bone/joint, oncology, and nuclear medicine.
|
10000
|
Incision & drainage of sebaceous cyst-one
|
CPT
|
This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
Evaluation and Management (99201-99499) – which includes hospital observation services, office, and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, intrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. Radiology (70000-79999) –including ultrasound, mammography, bone/joint, oncology, and nuclear medicine.
|
01999
|
Unlisted anesth procedure
|
CPT
|
This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
Evaluation and Management (99201-99499) – which includes hospital observation services, office, and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, intrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. Radiology (70000-79999) –including ultrasound, mammography, bone/joint, oncology, and nuclear medicine.
|
99199
|
Unlisted special svc px/rprt
|
CPT
|
Radiology (70000-79999) –including ultrasound, mammography, bone/joint, oncology, and nuclear medicine. Pathology and Laboratory (80000–89398) – including organ or disease-oriented panels, drug testing, therapeutic drug assays, evocative/suppression testing, consultations (clinical pathology), urinalysis, transfusion medicine, microbiology and more. Medicine (90281–99099; 99151–99199; 99500–99607) – including vaccines, toxoids, psychiatry, biofeedback, dialysis, gastroenterology, ophthalmology, special otorhinolaryngologic services, cardiovascular, noninvasive vascular diagnostic studies, pulmonary, allergy and clinical immunology, endocrinology and more. Category II pertains to clinical laboratory services. CPT codes for this category consist of secondary tracking codes employed for collecting information regarding the quality of care rendered, and performance measurement.
|
99199
|
Unlisted special svc px/rprt
|
CPT
|
Medicine (90281–99099; 99151–99199; 99500–99607) – including vaccines, toxoids, psychiatry, biofeedback, dialysis, gastroenterology, ophthalmology, special otorhinolaryngologic services, cardiovascular, noninvasive vascular diagnostic studies, pulmonary, allergy and clinical immunology, endocrinology and more. Category II pertains to clinical laboratory services. CPT codes for this category consist of secondary tracking codes employed for collecting information regarding the quality of care rendered, and performance measurement. The use of these codes is not mandatory. Breakdown of Category II CPT Codes are:
- Composite Measures (0001F-0015F)
- Patient Management (0500F-0575F)
- Patient History (1000F-1220F)
- Physical Examination (2000F-2050F)
- Diagnostic/Screening Processes or Results (3006F-3573F)
- Therapeutic, Preventive or Other Interventions (4000F-4306F)
- Follow-up or Other Outcomes (5005F-5100F)
- Patient Safety (6005F-6045F)
- Structural Measures (7010F-7025F)
Category III is reserved for emerging technologies, with CPT codes of 0016T-0207T.
|
90832
|
Psytx w pt 30 minutes
|
HCPCS
|
Pre-post ES for psychotherapies did not differ from pill placebos; this finding cannot be explained by heterogeneity, publication bias or allegiance effects. However, the decision on whether to choose psychotherapy, medications or a combination of the two should be left to the patient as drugs may have side effects, interactions and contraindications. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|There is no specific CPT code for eye movement desensitization and reprocessing:|
|Other CPT codes related to the CPB:|
|90832 - 90899||Psychotherapy, other psychotherapy, and other psychiatric services or procedures [not covered for eye movement desensitization and reprocessing therapy]|
|ICD-10 codes covered if selection criteria are met:|
|F43.10 - F43.12||Posttraumatic stress disorder|
|Z86.51||Personal history of combat and operational stress reaction|
|ICD-10 codes not covered for indications listed in the CPB:|
|F01.50 - F43.0
F43.20 - F99
|Mental disorders (other than posttraumatic stress disorder)|
|G54.6 - G54.7||Phantom limb (syndrome)|
|G89.21 -G89.29||Chronic pain, not elsewhere classified|
|G89.4||Chronic pain syndrome|
|M54.5||Low back pain [chronic back pain]|
|M54.9||Dorsalgia, unspecified [chronic back pain]|
|R56.00 - R56.9||Convulsions [psychogenic non-epileptic seizures]|
|
90899
|
HC UNLISTED PSYCHIATRIC SERVICE
|
HCPCS
|
Pre-post ES for psychotherapies did not differ from pill placebos; this finding cannot be explained by heterogeneity, publication bias or allegiance effects. However, the decision on whether to choose psychotherapy, medications or a combination of the two should be left to the patient as drugs may have side effects, interactions and contraindications. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|There is no specific CPT code for eye movement desensitization and reprocessing:|
|Other CPT codes related to the CPB:|
|90832 - 90899||Psychotherapy, other psychotherapy, and other psychiatric services or procedures [not covered for eye movement desensitization and reprocessing therapy]|
|ICD-10 codes covered if selection criteria are met:|
|F43.10 - F43.12||Posttraumatic stress disorder|
|Z86.51||Personal history of combat and operational stress reaction|
|ICD-10 codes not covered for indications listed in the CPB:|
|F01.50 - F43.0
F43.20 - F99
|Mental disorders (other than posttraumatic stress disorder)|
|G54.6 - G54.7||Phantom limb (syndrome)|
|G89.21 -G89.29||Chronic pain, not elsewhere classified|
|G89.4||Chronic pain syndrome|
|M54.5||Low back pain [chronic back pain]|
|M54.9||Dorsalgia, unspecified [chronic back pain]|
|R56.00 - R56.9||Convulsions [psychogenic non-epileptic seizures]|
|
90832
|
Psytx w pt 30 minutes
|
HCPCS
|
However, the decision on whether to choose psychotherapy, medications or a combination of the two should be left to the patient as drugs may have side effects, interactions and contraindications. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|There is no specific CPT code for eye movement desensitization and reprocessing:|
|Other CPT codes related to the CPB:|
|90832 - 90899||Psychotherapy, other psychotherapy, and other psychiatric services or procedures [not covered for eye movement desensitization and reprocessing therapy]|
|ICD-10 codes covered if selection criteria are met:|
|F43.10 - F43.12||Posttraumatic stress disorder|
|Z86.51||Personal history of combat and operational stress reaction|
|ICD-10 codes not covered for indications listed in the CPB:|
|F01.50 - F43.0
F43.20 - F99
|Mental disorders (other than posttraumatic stress disorder)|
|G54.6 - G54.7||Phantom limb (syndrome)|
|G89.21 -G89.29||Chronic pain, not elsewhere classified|
|G89.4||Chronic pain syndrome|
|M54.5||Low back pain [chronic back pain]|
|M54.9||Dorsalgia, unspecified [chronic back pain]|
|R56.00 - R56.9||Convulsions [psychogenic non-epileptic seizures]|
|
90899
|
HC UNLISTED PSYCHIATRIC SERVICE
|
HCPCS
|
However, the decision on whether to choose psychotherapy, medications or a combination of the two should be left to the patient as drugs may have side effects, interactions and contraindications. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|There is no specific CPT code for eye movement desensitization and reprocessing:|
|Other CPT codes related to the CPB:|
|90832 - 90899||Psychotherapy, other psychotherapy, and other psychiatric services or procedures [not covered for eye movement desensitization and reprocessing therapy]|
|ICD-10 codes covered if selection criteria are met:|
|F43.10 - F43.12||Posttraumatic stress disorder|
|Z86.51||Personal history of combat and operational stress reaction|
|ICD-10 codes not covered for indications listed in the CPB:|
|F01.50 - F43.0
F43.20 - F99
|Mental disorders (other than posttraumatic stress disorder)|
|G54.6 - G54.7||Phantom limb (syndrome)|
|G89.21 -G89.29||Chronic pain, not elsewhere classified|
|G89.4||Chronic pain syndrome|
|M54.5||Low back pain [chronic back pain]|
|M54.9||Dorsalgia, unspecified [chronic back pain]|
|R56.00 - R56.9||Convulsions [psychogenic non-epileptic seizures]|
|
V5363
|
Language screening
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
V5336
|
Repair communication device
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
92507
|
Treatment of speech, language, voice, communication, and/or hearing processing disorder
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
V5273
|
Ald for cochlear implant
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
92508
|
Speech/hearing therapy
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
V5269
|
Alerting device, any type
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
92510
|
Rehab for ear implant
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
L8615
|
Headset/headpiece for use with cochlear implant device, replacement
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
L8617
|
Transmitting coil for use with cochlear implant device, replacement
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
92601
|
PR ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
V5299
|
Hearing service
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
V5362
|
Speech screening
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
92604
|
Reprogram cochlear implt 7/>
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
L8618
|
Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
92603
|
PR ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
L8619
|
PROCESSOR SOUND SONNET/RONDO 3 KT
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
92602
|
Reprogram cochlear implt <7
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
69949
|
Unlisted px inner ear
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
L8616
|
Microphone for use with cochlear implant device, replacement
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated.
|
V5363
|
Language screening
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
V5336
|
Repair communication device
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
92507
|
Treatment of speech, language, voice, communication, and/or hearing processing disorder
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
V5273
|
Ald for cochlear implant
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
92508
|
Speech/hearing therapy
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
V5269
|
Alerting device, any type
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
92510
|
Rehab for ear implant
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
L8615
|
Headset/headpiece for use with cochlear implant device, replacement
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
L8617
|
Transmitting coil for use with cochlear implant device, replacement
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
92601
|
PR ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
V5299
|
Hearing service
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
V5362
|
Speech screening
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
92604
|
Reprogram cochlear implt 7/>
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
L8618
|
Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
92603
|
PR ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
L8619
|
PROCESSOR SOUND SONNET/RONDO 3 KT
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
92602
|
Reprogram cochlear implt <7
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
69949
|
Unlisted px inner ear
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
L8616
|
Microphone for use with cochlear implant device, replacement
|
HCPCS
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement.
|
V5363
|
Language screening
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
V5336
|
Repair communication device
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
92507
|
Treatment of speech, language, voice, communication, and/or hearing processing disorder
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
V5273
|
Ald for cochlear implant
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
92508
|
Speech/hearing therapy
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
V5269
|
Alerting device, any type
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
92510
|
Rehab for ear implant
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
L8615
|
Headset/headpiece for use with cochlear implant device, replacement
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
L8617
|
Transmitting coil for use with cochlear implant device, replacement
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
92601
|
PR ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
V5299
|
Hearing service
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
V5362
|
Speech screening
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
92604
|
Reprogram cochlear implt 7/>
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
L8618
|
Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
92603
|
PR ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
L8619
|
PROCESSOR SOUND SONNET/RONDO 3 KT
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
92602
|
Reprogram cochlear implt <7
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
69949
|
Unlisted px inner ear
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
L8616
|
Microphone for use with cochlear implant device, replacement
|
HCPCS
|
POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4/18/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section updated, CPT code 69949 added, HCPCS L8619, V5269, V5273, V5299, V5336, V5362, V5363 added
3/6/2003: Code Reference section updated, CPT code 92601, 92602, 92603, 92604 added
7/15/2004: Reviewed by MPAC, bilateral cochlear implantation considered investigational, Description section aligned with BCBSA policy # 7.01.05, definition of investigational added Policy Guidelines, Sources updated
10/5/2004: Code Reference section updated, CPT code 69949 deleted, CPT 92507 description revised, CPT 92508 added, ICD-9 procedure code 20.96, 20.97, 20.99, 95.49 added, ICD-9 diagnosis code range 389.10-389.18 listed separately, ICD-9 diagnosis 389.7 added, HCPCS L8619 note added, HCPCS V5269, V5273, V5299, V5336, V5362, V5363 deleted
3/22/2005: Code Reference section updated, CPT code 92510 description revised, HCPCS L8615, L8616, L8617, L8618 with Note: "See POLICY GUIDELINES for information regarding replacement of the external component of the cochlear implant" and effective date of 1/1/2005 added. 11/15/2005: HCPCS codes K0731, K0732, L8620 added
03/10/2006: Coding updated. CPT4 / HCPCS 2006 revisions added to policy
03/13/2006: Policy reviewed, no changes
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated.
|
L8627
|
Cochlear implant, external speech processor, component, replacement
|
HCPCS
|
ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table.
|
L8628
|
Cochlear implant, external controller component, replacement
|
HCPCS
|
ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table.
|
L8629
|
Transmitting coil and cable, integrated, for use with cochlear implant device, replacement
|
HCPCS
|
ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table.
|
L8627
|
Cochlear implant, external speech processor, component, replacement
|
HCPCS
|
Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices.
|
L8628
|
Cochlear implant, external controller component, replacement
|
HCPCS
|
Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices.
|
L8629
|
Transmitting coil and cable, integrated, for use with cochlear implant device, replacement
|
HCPCS
|
Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices.
|
L8627
|
Cochlear implant, external speech processor, component, replacement
|
HCPCS
|
ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; intent unchanged.
|
L8628
|
Cochlear implant, external controller component, replacement
|
HCPCS
|
ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; intent unchanged.
|
L8629
|
Transmitting coil and cable, integrated, for use with cochlear implant device, replacement
|
HCPCS
|
ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; intent unchanged.
|
L8627
|
Cochlear implant, external speech processor, component, replacement
|
HCPCS
|
3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; intent unchanged. Contraindications to cochlear implantation added to the policy guidelines.
|
L8628
|
Cochlear implant, external controller component, replacement
|
HCPCS
|
3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; intent unchanged. Contraindications to cochlear implantation added to the policy guidelines.
|
L8629
|
Transmitting coil and cable, integrated, for use with cochlear implant device, replacement
|
HCPCS
|
3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; intent unchanged. Contraindications to cochlear implantation added to the policy guidelines.
|
1000
|
HC ASAM LEVEL 3.7 MEDICALLY MONITORED INPATIENT
|
RC
|
08/25/2015: Code Reference section updated for ICD-10. 09/25/2015: Policy description updated regarding devices. Medically necessary policy statement updated to make correction: "100 HZ" updated to "1000 HZ." Policy Guidelines section updated regarding cochlear ossification and to add medically necessary and investigative definitions. SOURCE(S)Blue Cross Blue Shield Association policy # 7.01.05
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy.
|
1000
|
HC ASAM LEVEL 3.7 MEDICALLY MONITORED INPATIENT
|
RC
|
Medically necessary policy statement updated to make correction: "100 HZ" updated to "1000 HZ." Policy Guidelines section updated regarding cochlear ossification and to add medically necessary and investigative definitions. SOURCE(S)Blue Cross Blue Shield Association policy # 7.01.05
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document.
|
G0358
|
IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG
|
HCPCS
|
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
86816
|
HC HLA TYPING DR/DQ SINGLE AG
|
HCPCS
|
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.