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Medical Policy Update: Cochlear Implantation

Effective April 12, 2018, the guidelines of our medical policy, Cochlear Implantation, will also be applied to certain claims for services provided to patients enrolled in Horizon Blue Cross Blue Shield of New Jersey Medicare Advantage (MA) plans. Presently the guidelines of this medical policy have not been applied to claims for services provided to MA members.

We encourage you to review this policy content in our Medical Policy Manual.


Based on the guidelines of our medical policy, Cochlear Implantation, and the submitted diagnosis code(s), claims for services provided on and after April 12, 2018 to members enrolled in Horizon BCBSNJ MA plans will be processed as noted below.

  • Claims that include CPT® code 69930 and/or HCPCS codes L8614, L8615, L8616, L8617, L8618, L8619, L8621, L8622, L8623, L8624, L8627, L8628 and L8629 may pend while information required to determine medical appropriateness is requested and reviewed.
  • CPT® code 69930 and/or HCPCS codes L8614, L8615, L8616, L8617, L8618, L8619, L8621, L8622, L8623, L8624, L8627, L8628 and L8629 may be denied as not medically necessary 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 on and after April 12, 2018.

CPT® is a registered mark of the American Medical Association.

Published on: March 12, 2018, 14:25 p.m. ET
Last updated on: March 12, 2018, 14:29 p.m. ET