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Notification of Policy Revisions Effective May 31, 2022 (Posted March 31, 2022)
| Medical Guidelines | Revision |
|---|---|
| Balloon Ostial Dilation (Balloon Sinuplasty) | Medical Director review. Added “air fluid levels or opacification to support the diagnosis of sinusitis” to criteria 3 of the When Covered statement. Added “air fluid levels or opacification for” to the first Policy Guidelines sentence. Notification given March 31, 2022 for policy effective date May 31, 2022. |
| Radiosurgery, Stereotactic Approach | Under Policy Guidelines section, added Radiology Maximum Units guidelines for SBRT treatment course. Under Billing/Coding section, added CPT codes 77431 and 77470. Added Radiation Therapy Services Reimbursement Policy to Related Policies section. Medical Director review 3/2022. Notification given 3/31/22 for effective date 5/31/22. |
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