Medical Policy Revision: Opioid Antagonists Under Heavy Sedation or General Anesthesia as a Technique of Opioid Detoxification

Effective June 23, 2020, Horizon BCBSNJ will change the way we consider certain claims based on revisions to our medical policy Opioid Antagonists Under Heavy Sedation or General Anesthesia as a Technique of Opioid Detoxification.

Access our Medical Policy Manual to review this medical policy content.

Claims submitted for services provided on and after June 23, 2020 to patients enrolled in Horizon BCBSNJ Medicare Advantage (MA), Horizon BCBSNJ fully insured commercial and Administrative Services Only (ASO) plans will be processed as follows.

• Based on the submitted diagnosis code(s), information may be requested to help us determine the medical appropriateness of the services represented by HCPCS code J2310.
  
  Following our review of medical record information, these services may be denied as experimental/investigational, non-covered services.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service on and after June 23, 2020.