Medical policy updates
Below are links to updated or new policies. Remember, you can always find the latest updates to policies, as well as brief descriptions of what changed, under Authorizations > Medical policies > Policy changes list.
Effective Aug. 20, 2018
Criteria for the coverage of sympathectomy added and criteria updated to reflect sympathectomy is not covered if plantar hyperhidrosis is the only indication.
Rehabilitative/Habilitative Medicine Services 91318
Note indicating spinal manipulations by chiropractors are not covered for Priority Health Medicaid members age 21 or over was removed.
Spine Procedures 91581
Language updated to reflect The Coflex® interlaminar stabilization device for lumbar spinal stenosis is a covered benefit. Prior authorization is not required.
Vision Care 91538
Criteria updated to reflect "FDA approved" bypass stents for the treatment of open-angle glaucoma in combination with cataract surgery are a covered benefit.
Effective Oct. 1, 2018 – this policy was previously communicated on July 31, 2018
Thyroid-Related Procedures 91621 (NEW)
Prior authorization will be required effective Oct. 1, 2018 for commercial and Medicaid members and Jan. 1, 2019 for Medicare members.