Nobody Told You What Changed in Your Part B Drug Policy
UnitedHealthcare's September Medicare Advantage bulletin lists Medications/Drugs (Outpatient/Part B) as revised effective September 1, then prints the orthopedic change log underneath it: Girdlestone, 27299, 25449, 29840, 27122. Eight CGS coverage determinations took effect the same week with the synopsis field blank. The rest of the radar is the step therapy change that did get written down, Cigna rewriting August on September 4, and Aetna's claim edits landing December 1.
UnitedHealthcare revised its Medicare Advantage policy for outpatient Part B drugs effective September 1. The change log it published for that policy describes hip surgery.
Not a drug. Not a J code. Hip surgery.
"How do you diff a policy whose published change log belongs to a different policy?"
A Change Log for a Different Policy
The September Medicare Advantage Medical Policy Update Bulletin carries six entries. Three of them took effect the day the bulletin's own month started: Ambulatory Electrocardiographic Monitoring, Computerized Dynamic Posturography, and Medications/Drugs (Outpatient/Part B).
The AECG entry is real work. It rewrites coverage for states with no LCD on event monitors, Holter monitors and patch recorders, adds pre- and post-TAVR arrhythmia monitoring as reasonable and necessary, and drops a long list of ICD-10 codes into two code families.
The Medications/Drugs entry reads, in its entirety: removed language addressing acetabuloplasty and resection of the femoral head, renamed a heading from Surgery of the Hand or Wrist to Surgery of the Wrist or Thumb, added 27299 for femoroacetabular impingement, removed 25449 and 29840, removed 27122.
That is the Joint Procedures row, word for word, pasted into the Part B drug row. Page 4 of the bulletin carries the header "Medications/Drugs (Outpatient/Part B) (continued)" above a table of hip and wrist CPT codes.
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