Medical Policy Update: Seat Lift Mechanisms
Effective April 16, 2018, the guidelines of our medical policy, Seat Lift Mechanisms, will also be applied to certain claims for services/supplies 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 MA members.
We encourage you to review this policy content in our Medical Policy Manual.
Based on the guidelines of our medical policy, Seat Lift Mechanisms, claims for services/supplies provided on and after April 16, 2018 to members enrolled in Horizon BCBSNJ MA plans will be processed as noted below.
- Claims that include HCPCS codes E0627, and/or E0629 may pend, based on the submitted diagnosis code(s), while information required to determine medical appropriateness is requested and reviewed.
- HCPCS code E0172 included on claims will be denied as a service/supply that is not medically necessary regardless of the submitted diagnosis code(s).
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 16, 2018.
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