Medical Policy Update: Transcatheter Pulmonary Valve Implantation
Effective April 20, 2018, the guidelines of our medical policy, Transcatheter Pulmonary Valve 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, Transcatheter Pulmonary Valve Implantation, claims for services provided on and after April 20, 2018 to members enrolled in Horizon BCBSNJ MA plans will be processed as noted below.
- Claims that include CPT® code 33477 will be denied as a not medically necessary service 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 20, 2018.
CPT® is a registered mark of the American Medical Association.