Medical Policy Revision: Progesterone Therapy to Reduce Preterm Delivery in High-Risk Pregnancies
According to our posted medical policy, Progesterone Therapy as a Technique to Reduce Preterm Delivery in High Risk Pregnancies, claims submitted for progesterone therapy should be pended while information required for us to determine medical necessity of this therapy is requested and reviewed. Claims for progesterone therapy processed since November 2013 have not been pending for this medical appropriateness review due to a system issue.
We have reposted our medical policy, Progesterone Therapy as a Technique to Reduce Preterm Delivery in High Risk Pregnancies, and, beginning on November 3, 2014, claims submitted for progesterone therapy for dates of service on and after November 3, 2014 will pend while information to determine medical necessity is requested and reviewed.
This medical policy is available in our online Medical Policy Manual.
Unless Horizon BCBSNJ gives written notice that this policy has been cancelled or postponed, the policy will be applied to claims for dates of service on and after November 3, 2014.