Medical Policy Updates

Medical Policy Update for September 30, 2022

Medical Guidelines Reason for Update
Cranial Electrotherapy Stimulation (CES) and Auricular Electrostimulation Added code A4596 to Billing/Coding section.
Diagnosis of Vaginitis including Multi-target PCR Testing AHS – M2057 Added CPT code 0352U to Billing/Coding section.
Diagnostic Testing of Sexually Transmitted Infections AHS – G2157 Added new codes 0353U and 0354U to Billing/Coding section.
Gene Expression Profiling and Protein Biomarkers for Prostate Cancer AHS - M2166 Added CPT code 0339U to Billing/Coding section. Corrected typo in policy statement. No change to intent of policy statement.
Investigational (Experimental) Services COVID-19 related changes extended “effective from March 6, 2020 through December 31, 2022. We will reevaluate if an additional extension is needed as we approach December 31.” Medical Director review 9/2022.
Laboratory Procedures Medical Policy AHS - R2162 Added codes 0341U, 0342U and 0351U to Billing/Coding section.
Liquid Biopsy AHS-G2054 Added the following CPT codes to Billing/Coding section: 0332U, 0333U, 0337U, 0338U, 0343U, 0346U.
Microsatellite Instability and Tumor Mutational Burden Testing AHS-M2178 Added CPT 0334U to Billing/Coding section.
Minimal Residual Disease (MRD) AHS-M2175 Added CPT code 0340U to Billing/Coding section.
Pharmacogenetics Testing AHS – M2021 Added CPT codes 0345U, 0347U, 0348U, 0349U and 0350U to Billing/Coding section.
Red Blood Cell Molecular Testing AHS-M2170 Reviewed by Avalon 2nd Quarter 2022 CAB. Medical Director review 8/2022. Added CPT code 0282U to Billing/Coding section effective 10/1/2022. Updated related policies section. Updated policy guidelines and references sections.
Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease AHS – G2110 Added CPT code 0344U to Billing/Coding section.
Skin and Soft Tissue Substitutes The following codes were added to the Billing/Coding section: A2014, A2015, A2016, A2017, A2018 effective 10/1/2022.
Therapeutic Radiopharmaceuticals in Oncology Added HCPCS codes A9607 and A9800 to Billing/Coding section. Effective 10/1/22.
Tumor-Treatment Fields Therapy Under related policies section: changed title of related policy AHS-M2139 to Molecular Analysis for Gliomas from Analysis of MGMT Promotor Methylation in Malignant Gliomas. No change to policy statement.
Whole Genome and Whole Exome Sequencing AHS – M2032 Added CPT codes 0335U and 0336U to Billing/Coding section.