Providers

Medical Policy Upcoming Updates

Notification Date: August 16, 2017

Below are the policies that are new or have been reviewed, along with the determination and summary of any changes.

Coverage Policies

Policy Title	Status	Effective Date	Determination	Summary of Change
Apolipoprotein E (APOE) Genetic Testing for Prediction and Management of Cardiovascular Disease	Re-reviewed	10/16/2017	Investigative and therefore not covered	No change in determination
Bronchial Thermoplasty	Re-reviewed	10/16/2017	Investigative and therefore not covered	No change in determination
Dietitian Services	Re-reviewed	10/16/2017	Covered	No change in determination
Gastrointestinal Monitoring System (SmartPill®)	Re-reviewed	10/16/2017	Investigative and therefore not covered	No change in determination
Testing for Neutralizing Antibodies to Interferon Beta in the Management of Multiple Sclerosis	Re-reviewed	10/16/2017	Investigative and therefore not covered	No change in determination
Thermography	Re-reviewed	10/16/2017	Investigative and therefore not covered	No change in determination
VasClip®	Re-reviewed	10/16/2017	Not Covered	No change in determination

The updated clinical policies and guidelines above will be available as of their effective date, as noted. View policies and guidelines.

To request paper copies of a policy, please leave a message at the Medica Provider Literature Request Line: 1-800-458-5512, option 1, then option 5, then ext. 2-2355.

Where information conflicts with applicable state and/or federal law, Medica follows such applicable federal and/or state law.