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Medical Policy Update: Ultrasound Accelerated Fracture Healing Device

Effective February 14, 2019, we will change the way we process claims for certain services based on revisions to our medical policy, Ultrasound Accelerated Fracture Healing Device.

Access our Medical Policy Manual to review this medical policy content.¹


Claims submitted for services provided on and after February 14, 2019 will be processed as noted below.

  • Medical record information may be requested to help us determine the medical appropriateness of the services represented by CPT® code 20979 and/or HCPCS code E0760 included on claims for services provided to patients enrolled in Horizon BCBSNJ Medicare Advantage (MA) plans.

    Following our review of medical record information, the services represented by these codes may be denied as not medically necessary.

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 February 14, 2019.

¹ The content of Horizon BCBSNJ medical policies that apply to Horizon BCBSNJ MA plans may include reference to pertinent National Coverage Determinations (NCDs) and/or Local Coverage Determinations (LCDs). We follow Centers for Medicare & Medicaid Services (CMS) guidelines, NCDs and/or LCDs in our processing of claims for services provided to our MA members. For those services where no LCD or NCD exists, claims for MA members will be processed based on our policy guidelines.

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

Published on: January 14, 2019, 14:03 p.m. ET
Last updated on: January 14, 2019, 14:04 p.m. ET