Medical Policy Updates

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Medical Policy Update for July 27, 2021

Medical Guidelines Reason for Update
Artificial Intervertebral Disc References added. Expired code 0375T removed from Billing/Coding section. Added Simplify® Cervical Artificial Disc to the list of FDA approved cervical devices. Medical Director review. Deleted "Prior surgery at the treated level” from the list of exclusions in the When Not Covered section.
General Inflammation Testing AHS – G2155 Specialty Matched Consultant Advisory Panel 02/17/2021. Medical Director review. No change to policy statement.
Genetic Testing for Ophthalmologic Conditions AHS-M2083 Specialty Matched Consultant Advisory Panel review 6/16/2021. Medical Director review 6/2021. Reviewed by Avalon 2nd Quarter 2021 CAB. Updated Policy Guidelines, guidelines/recommendations and added references. Added Note 1. No change to policy statement.
Hemoglobin A1c AHS – G2006 Specialty Matched Consultant Advisory Panel 02/17/2021. Medical Director review 2/2021. No change to policy statement.
Oral Screening Lesion Identification Systems and Genetic Screening AHS – G2113 Specialty Matched Consultant Advisory Panel 02/17/2021. Medical Director review 2/2021. No change to policy statement.
Quantose Impaired Glucose Tolerance (IGT) Test AHS - G2135 Specialty Matched Consultant Advisory Panel 02/17/2021. Medical Director review 2/2021. No change to policy statement.
Testing of Homocysteine Metabolism Related Conditions AHS – M2141 Specialty Matched Consultant Advisory Panel 02/17/2021. No change to policy statement.
Urinalysis and Urine Culture Testing for Bacteria AHS – G2156 Specialty Matched Consultant Advisory Panel 02/17/2021. Medical Director review 2/2021. No change to policy statement.
Vitamin B12 and Methylmalonic Acid Testing AHS – G2014 Specialty Matched Consultant Advisory Panel 02/17/2021. Medical Director review 2/2021. No changes to policy statement.
Vitamin D Testing AHS – G2005 Specialty Matched Consultant Advisory Panel 02/17/2021. No changes to policy.