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MAC Newsletters - Archive

2007

MAC-01-07 - Published 6/01/07

• Ophthalmology Liaison (consent ballot October 2006)
  • Scanning Laser Ophthalmoscopy (SLO) Test for Glaucoma and Optical Coherence Tomography (OCT) for Retinal Conditions
• Orthopedic Liaison (January 10, 2007)
  • Continuous Passive Motion (CPM) for Home Use
  • Intra-articular Hyaluronan Injections for Osteoarthritis of the Knee
  • Meniscal Allograft Transplantation
• Chiropractic Liaison (January 25, 2007)
  • Informational Items only
• Podiatry Liaison (February 8, 2007)
  • Informational Items only
• Oncology Liaison (February 20, 2007)
  
  • Gene Expression Assay for Breast Cancer Treatment
• Radiology Liaison (February 28, 2007)
  • Computerized Tomography (CT) Coronary Artery Scans
  • Extracranial Carotid Angioplasty/Stenting
  • High Dose Rate (HDR) Breast Brachytherapy With HDR Radioactive Source via MammoSite Catheter
  • Magnetic Resonance Imaging (MRI) and Computer Assisted Detection (CAD)
  • Virtual Colonoscopy

2006

MAC-03-06 - Published 12/29/06

• Family Practice Liaison (July 11, 2006)
  • Continuous Glucose Monitoring System
  • Pediatric Growth Hormone
  • Respiratory Syncytial Virus
• OB/GYN Liaison (July 19, 2006)
  • Informational Items Only
• Pediatric Liaison (August 2, 2006)
  • Chest Oscillation
  • Continuous Glucose Monitoring System
  • Pediatric Growth Hormone
  • Respiratory Syncytial Virus
• Internal Medicine Liaison (August 30, 2006)
  • Adult Growth Hormone
  • Chest Oscillation
  • Continuous Glucose Monitoring System
  • Insulin Pumps
  • Video EEG

MAC-02-06 - Published 9/29/06

• Anesthesiology Liaison (May 9, 2006)
  • Epidural Lysis of Adhesions
  • Moderate Sedation/Monitored Anesthesia
• Behavioral Health Liaison Committee (June 6, 2006)
  • Deep Brain Stimulation for Obsessive Compulsive Disorder
  • Eye Movement Desensitization and Reprocessing for Post
    Traumatic Stress Disorder
  • Vagus Nerve Stimulation for Depression
• Optometric Liaison (May 25, 2006)
  • Informational Items Only

MAC-01-06 - Published 6/01/06

• Otolaryngology Liaison (Consent Ballot December 8, 2005)
  • Bone Anchored Hearing Aids (BAHA)

 

2005

MAC-03-05 - Published 12/30/05

• Cardiology Liaison (April 27, 2005)
  • Ambulatory Event Monitors
• Ophthalmology Liaison (Consent Ballot May 4, 2005)
                                and
  Optometry Liaison (May 26, 2005)
  • Pachymetry
• Otolaryngology Liaison (September 14, 2005)
  • Cochlear Implants
  • LAUP
  • UPPP and Tongue Base Reduction Surgery
• Surgery Liaison (August 17, 2005)
  • BRCA I and BRCA II
  • MRI Breast
  • Wound VAC
• Urology Liaison (August 24, 2005)
  • Botox for Overactive Bladder
  • Deflux for VUR
  • Water Induced Thermotherapy for BPH

MAC-02-05 - Published 09/30/05

Orthopedic Liaison (January 5, 2005)
                    and
Anesthesia Liaison (May 10, 2005)
• Regional Nerve Blocks and General Anesthesia
  
Cardiology Liaison (April 27, 2005)
• Cardiovascular MRI and MRA
• CT Coronary Artery Scans
  
Optometric Liaison (May 26, 2005)
• Sensorimotor and Neurobehavioral Status Exams

MAC-01-05 - Published 06/01/05

• Ad Hoc Home Phototherapy
  • Home Phototherapy
• Ad Hoc Therapies
  • Documentation of Medical Services
  • Heat and Cold Therapies
  • Unit Limitations (Modalities and Therapeutic
• Orthopedic (January 5, 2005)
  • Extracorporeal Shock Wave Therapy
  • Kyphoplasty
• Internal Medicine Liaison (January 26, 2005)
  • Continuous Glucose Monitoring
  • Intravenous Immunoglobin Globulin
• Podiatry Liaison (February 3, 2005)
  • Extracorporeal Shock Wave Therapy
• Radiology Liaison (February 8, 2005)
  • CT Coronary Artery Scan
  • Kyphoplasty
  • Magnetic Resonance Imaging (MRI) Breast
  • Positron Emission Tomography (PET)
• Oncology Liaison (February 15, 2005)
  • Intravenous Immunoglobin Globulin
  • Positron Emission Tomography (PET)

 

2004

MAC-03-04 - Published 12/30/04

• Family Practice Liaison (July 13, 2004)
  • Orthotic Cranioplasty for Plagiocephaly Without Synostosis
  • Surgical Treatment of Gynecomastia
• Pediatric Liaison (July 28, 2004)
  • Orthotic Cranioplasty for Plagiocephaly Without Synostosis
  • Surgical Treatment of Gynecomastia
• Otolaryngology Liaison (August 11, 2004)
  • Allergy Testing
  • Excision of Parotid Tumor or Parotid Gland
  • Uvulopalatopharyngoplasty and Tongue Base Reduction Surgery
• Surgery Liaison (August 18, 2004)
  • Surgical Treatment of Gynecomastia
  • Transesophageal Endoscopy Therapy
  • Wireless Capsule Endoscopy
• General Information from MAC
  • Assistant at Surgery

MAC-02-04 - Published 9/22/04

• Orthopedic Liaison (January 7, 2004)
  • Lateral Release – Knee
• Optometric Liaison (May 27, 2004)
  • Extended Fundus Photography

MAC-01-04 - Published 5/27/04

• General MAC Update (April 22, 2004)
  • Assistant at Surgery (CPT Code 20982)
• Otolaryngology Liaison (December 3, 2003)
  • Allergy Immunotherapy
  • Allergy Testing
  • Uvulopalatopharyngoplasty (UPPP) and Tongue Base Reduction Surgery
• Orthopedic Liaison (January 7, 2004)
  • Content of Service With Arthroscopy Shoulder Procedures
  • Equipment for Cold Therapy
  • Extracorporeal Shock Wave Therapy (ESWT) (Orthotripsy)
  • Extracorporeal Shock Wave Therapy (ESWT) - Tennis Elbow
  • Osteochondral Knee Allograft and Autografts
• Radiology Liaison (February 10, 2004)
  • MRI of the Breast
  • Virtual Colonoscopy
• Oncology Liaison (February 17, 2004)
  • Prophylactic Mastectomy

2003

MAC-04-03 - Published 1/02/04

• General MAC Update (November 6, 2003)
  • Assistant at Surgery codes (HCPCS Code S2091)
• Family Practice Liaison (July 22, 2003)
  • Ambulatory Blood Pressure Monitoring
  • Respiratory Syncytial Virus (RSV) Guideline
  • Home Phototherapy
  • Wireless Capsule Endoscopy
  • Osteoporosis Screening
  • Continuous Glucose Monitoring
• OB/GYN Liaison (July 23, 2003)
  • Osteoporosis Screening
  • Continuous Glucose Monitoring
  • Prophylactic Oophorectomy/Hysterectomy
  • Hysteroscopic Tubal Sterilization: Essure Micro-Insert
• Pediatrics Liaison (July 30, 2003)
  • Respiratory Syncytial Virus (RSV) Guideline
  • Home Phototherapy
  • Continuous Glucose Monitoring
• Otolaryngology Liaison (August 13, 2003)
  • Cautery and/or Ablation of Turbinates
• Surgery Liaison (August 20, 2003)
  • Prophylactic Oophorectomy/Hysterectomy
  • Radiofrequency Ablation of Liver Tumors
  • Negative Pressure Wound Therapy (NPWT)
  • Lung Volume Reduction Surgery (LVRS)
• Urology Liaison (August 27, 2003)
  • Prostate Specific Antigen (PSA)
  • Cryoablation of the Prostate
  • Sural Nerve Graft
  • Ultrasound for Post-Voiding
• Internal Medicine Liaison (September 3, 2003)
  • Ambulatory Blood Pressure Monitoring
  • Wireless Capsule Endoscopy
  • Osteoporosis Screening
  • Continuous Glucose Monitoring
  • Lung Volume Reduction Surgery (LVRS)
  • Immune Globulin for the Treatment of Amyotrophic Lateral Sclerosis (ALS)
  • Enterix InSure™ Fecal Occult Blood Test

MAC-03-03 - Published 9/19/03

• 2003 AMA CPT Codes Considered Not Medically Necessary
  

MAC-02-03 - Published 5/28/03

• General MAC Update (April 24, 2003)
  
  • Assistant At Surgery Not Medically Necessary
• Podiatry Liaison (February 6, 2003)
  • Noninvasive Bone Growth Stimulation
  • Unna Boot
• Radiology Liaison (February 11, 2003 and April 1, 2003)
  • Prostate Brachytherapy with Permanent Seeds and High Dose Rate Prostate Brachytherapy
  • High Dose Rate Breast Brachytherapy with Permanent Seeds Via Mammo-Site Catheter
  • Tumor Markers CA-27.29 and CA-15-3
  • Ultrasound of Breast
  • Positron Emission Tomography (PET) Scans
  • Radiofrequency Ablation of Liver Tumors
  • Chemoembolization of Primary or Metastatic Carcinoma Liver Tumors
  • Kyphoplasty/Vertebroplasty
  • Magnetic Resonance Venography (MRV)
  • Magnetic Resonance Angiography (MRA) Guidelines
• Orthopedic Liaison (February 12, 2003)
  • Noninvasive Bone Growth Stimulation
  • Kyphoplasty/Vertebroplasty
  • Service Content of Arthroscopy Shoulder Procedures
• Oncology Liaison (February 18, 2003 and April 1, 2003)
  • Prostate Brachytherapy with Permanent Seeds and High Dose Rate Prostate Brachytherapy
  • Tumor Markers CA-15-3 and CA-27.29
  • High Dose Rate Breast Brachytherapy with Permanent Seeds Via Mammo-Site Catheter
  • Positron Emission Tomography (PET) Scans
  • Radiofrequency Ablation of Liver Tumors
  • Chemoembolization of Primary or Metastatic Carcinoma Liver Tumors

MAC-01-03 - Published 01/16/03

• General Information From MAC (11/7/02)
  Assistant at Surgery Not Medically Necessary
  
  
• OB/GYN Liaison (7/24/02)
  Fetal Fibronectin
  Uterine Artery Embolization (UAE)
  
  
• Pediatric Liaison (7/31/02)
  Pediatric Pneumogram
  Repair of Septal Defect
  Respiratory Syncytial Virus Immune Globulin (RSV-Ig) Guideline
  Transitional Growth Hormone
  
  
• Otolaryngology Liaison (8/14/02)
  Osteointegrated Implants
  Lung Volume Reduction Surgery (LVRS)
  Cochlear Implants
  
  
• Surgery Liaison (8/21/02)
  Removal of Impacted Cerumen, One or Both Ears
  Breast Biopsy In Addition To Radical Mastectomy
  Coding Breast Capsulectomy and Implant Removal
  Endoscopic Gastroplasty
  
  
• Internal Medicine Liaison (9/15/02)
  Interferon Gamma-1B (i.e. Actimmune) for Pulmonary Fibrosis
  VQ or CTA for Pulmonary Embolus
  Lung Volume Reduction (LVRS)

2002

MAC-02-02 - Published 9/25/02

General Information From MAC (met 8/08/02)

• Assistant At Surgery Not Medically Necessary
  
  Cardiology Liaison (5/8/02)
  
• Coronary Magnetic Resonance Angiography
  
  Ophthalmology Liaison (5/22/02)
  
• Blepharoplasty and Blepharoptosis
  
• Diagnosis Codes for Contacts, Glasses, and Lenses
  
  

MAC-01-02 - Published 7/11/02

General Information From MAC (met 5/16/02)

• Assistant At Surgery Denied Codes
  
  OB Epidural (Ad Hoc met 1/22/02)
  
• CPT Codes for 2003
  
  Orthopedic Liaison (met 1/23/02)
  
• Bilateral Spinal Procedures
  
• Electrical Bone Growth Stimulator
  
• Operating Microscope
  
• CPM To Be Used With ACI
  
• Percutaneous Vertebroplasty
  
• Extracorporeal Shock Wave Therapy (Orthotripsy) for Plantar Fasciitis
  
  IVIG (Ad Hoc met 2/01/02)
  
• Immunodeficiency Syndromes
  
• Internal Medicine Liaison (met 2/06/02)
  
• Adult Growth Hormone Therapy
  
• Camera PillInterferon Gamma-1B (i.e., Actimmune)
  
• Osteoporosis Rescreening Guidelines
  
• Electron-Beam Computerized Tomography (EBCT) Screening for Cardiovascular Calcium Deposits
  
  Podiatry Liaison (met 2/7/02)
  
• Extracorporeal Shock Wave Therapy (Orthotripsy) for Plantar Fasciitis
  
• Electrical Bone Growth Stimulator
  
  Radiology Liaison (met 2/12/02)
  
• Percutaneous Vertebroplasty
  
• Positron Emission Tomography (PET)
  
• Additional Diagnosis Codes Covered for Diagnostic Mammography
  
• Brachytherapy
  
• MRI of the Breast
  
• Electron-Beam Computerized Tomography (EBCT) Screening for Cardiovascular Calcium Deposits
  
• Breast Ductal Lavage
  
  Oncology Liaison (met 2/19/02)
  
• Brachytherapy
  
• Breast Ductal Lavage
  BRCA I and BRCA II Guidelines Updated
  

2001

MAC-03-01 - Published 12/31/01

• Assistant at Surgery Not Allowed
• Computerized Tomography Angiography (CTA)
• Cryosurgical Ablation of the Prostate (Urology)
• Extracorporeal Magnetic Innervation (ExMI) (Urology)
• Laser Procedure Codes (Ophthalmology)
• Nasal Vestibular Stenosis (Otolaryngology)
• Osteointegrated and Cochlear Implants (Otolaryngology)
• Sleep Apnea and Post Operative Sleep Studies (Otolaryngology)
• Transuretheral Destruction of Prostate Tissue by Water Induced Thermotherapy (Urology)
• Tympanoplasty and Tube Placement (Otolaryngology)
• Urological Stents (Urology)
• Uvulopalatopharyngoplasty (UPPP) (Otolaryngology)
• Visudyne Therapy (Ophthalmology)

MAC-02-01 - Published 09/27/01

• BRCA I, BRCA II, and Prophylactic Mastectomy (Oncology)
• Computerized tomography Angiography (Radiology)
• Intensity Modulated Radiation Therapy (IMRT)
• Magnetic Resonance Angiography (MRA) (Radiology)
• Positron Emission Tomography (PET) (Radiology)
• Total Parental Nutrition (TPN) (Oncology)

MAC-01-01 - Published 06/05/01

• Adult Growth Hormone Therapy Guidelines (Internal Medicine)
• Assistant at Surgery Codes
• Autologous Chondrocyte Transplantation (ACT) (Orthopedic)
• Bone Growth Substitute (Orthopedic)
• Continuous Glucose Monitoring (Internal Medicine)
• Continuous Passive Motion (CPM) (Orthopedic)
• Neonatal Intensive Care (Pediatric)
• Neuromuscular Stimulators
• Pediatric Growth Hormone Therapy (Pediatric)
• Percutaneous Vertebroplasty (Orthopedic)
• Prophylactic Mastectomy (OB/GYN)
• Remicade Administration Becomes More Flexible (Internal Medicine)
• Superior Labrum Anterior Posterior Procedure (SLAP) (Orthopedic)
• Uterine Artery Embolization (OB-GYN)
  

2000

MAC-02-00 - Published 06/28/00

• Stress Test Prior To Cardiac Rehabilitation (Cardiology)
• Assistant at Surgery (Surgery)
• Autologous Bone Marrow Transplant (AMBT) for Breast Cancer (Oncology)
• Billing Contacts with an Approved Diagnosis (Ophthalmology)
• Billing Intravenous Immune Globulin Treatment For Multifocal Neuropathy (Internal Medicine)
• Botox Rehabilitation and
• Pain Management
• Botox Treatment Approved for Specific Diagnoses (Otolaryngology)
• Claim Status Online
• Continuing Medical Physics Consultation (Radiology)
• Contrast Agents/Radioisotopes (Radiology)
• CPT Code 93320 No Longer Content of Service of CPT 93325 (Cardiology)
• Deleted Codes (Optometry)
• Drugs No Longer Reviewed
• Enterolysis and Enterectomy (Surgery)
• HCPCS Code V2710 (Optometry)
• High Dose Chemotherapy (HDC) with Autologous Stem Cell Support (AuSCS) (Oncology)
• ICD-9 Diagnosis Code 367.9 (Ophthalmology)
• Intradiscal Electrothermal Therapy (IDET) Rehabilitation and
• Pain Management
• Iridotomy/Iridectomy by Laser Surgery (Ophthalmology)
• Knee X-Rays (Radiology)
• MRI & MRA (Radiology)
• Multiple Sclerosis (MS) Definitions (Internal Medicine)
• OTOLam for Ear Infection (Otolaryngology)
• Radiofrequency Ablation of the Tongue Base (Otolaryngology)
• Revision of Guidelines for Reduction Mammoplasty (Surgery)
• Stereotactic Needle Localization and Biopsy (Radiology)
• Surgery Assistants (Cardiology)
• Therapeutic Radiology Simulation-Aided Field Setting (Radiology)
• Visudyne Therapy (Ophthalmology)
• Warm Up Wound Therapy Rehabilitation and
• Pain Management

MAC-01-00 - Published 06/28/00

• Acupuncture
• Ambulatory blood Pressure Monitoring
• Botox for Achalsia
• Enbrel for Psoriatic Arthritis
• Endometrial Ablations
• Endometrial Biopsy and Colposcopy
• IVIG for Multifocal Neuropathy
• Occipital Nerve Stimulator
• Osteoporosis Screening Guidelines
• Predetermination Request Form attached
• Treatment of Secondary Progressive Multiple Sclerosis
• Vax-D
• Assistant at Surgery Listing
• New Immunization - Prevnar
  

1999

MAC-02-99 - Published 01/31/00

• Adult Growth Hormone Therapy (Internal Medicine)
• Assistant at Surgery Denial List (Surgery)
• Assistant at Surgery Denial List (Orthopedics)
• Bone Growth Stimulators (E0747) (Orthopedics)
• Brachytherapy for Prostate Cancer (Radiology)
• Continuous Passive Motion (CPM) Therapy (Orthopedics)
• Contrast Agents/Radioisotopes (Radiology)
• Coronary Arteries (Cardiology)
• Diagnosis Codes for Diagnostic Mammography Radiology
• Donor Cardiectomy (Surgery)
• Electro Thermal Capsular Shrinkage (Orthopedics)
• Extracorporeal Magnetic Innervation (Urology)
• Guidelines for Synagis IM
• Intravenous Immunoglobulin (IVIG) for Multifocal Motor Neuropathy (Internal Medicine)
• LYMErix - Lyme Disease Vaccination (Internal Medicine)
• Lymphedema Management Program Surgery
• Magnetic Resonance Angiography (MRA) (Radiology)
• Medical Emergency Diagnosis Codes (Optometry)
• Non-Ionic Contrast Media (Radiology)
• OB Epidural Anesthesia for Delivery (Anesthesia)
• Ophthalmic Laser Procedure 67220 Guidelines (Ophthalmology)
• Positron Emission Tomography (PET) (Radiology)
• Procuren Growth Factor Therapy (Surgery)
• Prophylactic Mastectomy (Surgery)
• Proton Beam Treatment Delivery for Prostate Cancer (Radiology)
• Radiofrequency Ablation of the Liver Surgery
• Scanning Laser Ophthalmic Diagnostic Imaging (Ophthalmology)
• Stereotactic Needle Localization & Biopsy Using a Mammotome (Radiology)
• Synvisc and Hyalgan Guidelines - Revised (Orthopedics)
• Thoratec Ventricular Assist Device (VAD) (Cardiology)
• Total Parenteral Nutrition (TPN) Therapy Guidelines (Internal Medicine)
• TPN for Cancer Patients (Internal Medicine)
• Transmyocardial Laser Revascularization (TMLR) (Cardiology)
• Treatment of Progressive Type Multiple Sclerosis (Internal Medicine)
• Ultrasonic Treatment of Peyronie's Disease

MAC-01-99 - Published 05/19/99

• Adult Growth Hormone Therapy (Internal Medicine)
• Alpha Prefix - Insured's Identification Number
• Assistant at Surgery Denial List (OB/GYN)
• Assistant at Surgery Denial List attached
• Assistant at Surgery Denial List (Podiatry)
• Billing Procedures 57282 and 57250 (OB/GYN)
• Botox for Spasticity (Pediatric & Internal Medicine)
• Event Recording Interpretation (Apnea Monitor Downloads) (Pediatric)
• Infliximab Drug (Internal Medicine)
• Insulin Pump (Internal Medicine)
• Major/Minor Classification List attached
• Sahara Ultrasound System Bone Density Testing (Internal Medicine)
• Salivary Estriol (SalEst) Testing (OB/GYN)
• Strappings
• Synagis IM (Pediatric Guidelines
• ThAIRapy Vest (Internal Medicine)
• Lung Volume Reduction Surgery (LVRS) (Internal Medicine)

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