{"id":8592,"date":"2024-08-05T17:20:39","date_gmt":"2024-08-05T17:20:39","guid":{"rendered":"http:\/\/hnetalk.com\/provider\/?p=8592"},"modified":"2024-08-05T17:20:39","modified_gmt":"2024-08-05T17:20:39","slug":"clinical-review-criteria-august-2024","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/clinical-review-criteria-august-2024\/","title":{"rendered":"Clinical Review Criteria (August 2024)"},"content":{"rendered":"<p>Health New England reviews clinical policies and updates accordingly. These policies reside at healthnewengland.org\/Providers\/Resources. Once on the Resources page, click on Behavioral Health\/Medical Policies to learn more.<\/p>\n<ul>\n<li><strong>Percutaneous Neuroablation<\/strong>\n<ul>\n<li>Effective 8\/1\/2024<\/li>\n<li>Updated with non-coverage of Intraosseous Basivertebral Nerve Ablation (CPT codes 64628 and 64629) as it is not covered by MassHealth.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Cosmetic and Reconstructive Procedures<\/strong>\n<ul>\n<li>Update effective 8\/1\/2024<\/li>\n<li>Removed prior authorization from CPT 67911<\/li>\n<\/ul>\n<\/li>\n<li><strong>Rhinoplasty and Other Nasal Surgeries<\/strong>\n<ul>\n<li>Annual Review effective 9\/1\/2024<\/li>\n<li>Minor criteria and code updates<\/li>\n<li>MassHealth guidelines added for Medicaid<\/li>\n<li>Added CPT codes 31242 and 31243 as experimental\/investigational (codes were effective on 1\/1\/2024)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, extension 5000. A representative is available Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. You may also send an email to providerrelations@hne.com.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Health New England reviews clinical policies and updates accordingly. These policies reside at healthnewengland.org\/Providers\/Resources. Once on the Resources page, click on Behavioral Health\/Medical Policies to learn more. Percutaneous Neuroablation Effective 8\/1\/2024 Updated with non-coverage of Intraosseous Basivertebral Nerve Ablation (CPT codes 64628 and 64629) as it is not covered by MassHealth. Cosmetic and Reconstructive Procedures [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[],"class_list":["post-8592","post","type-post","status-publish","format-standard","hentry","category-provider-newsletter"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-2eA","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8592","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=8592"}],"version-history":[{"count":2,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8592\/revisions"}],"predecessor-version":[{"id":8594,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8592\/revisions\/8594"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=8592"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=8592"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=8592"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}