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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

December 2016

Update: New Coding for CT Screening for Lung Cancer


Harvard Pilgrim has updated the CT Screening for Lung Cancer Medical Policy to include new coding requirements. For dates of service beginning January 1, 2017, please submit your request for prior authorization and reimbursement for lung cancer CT screening using HCPCS code G0297, rather than CPT code 71250. Prior authorization for outpatient diagnostic imaging will continue to be performed through NIA Magellan; providers may submit their request through NIA Magellan’s website at www.radmd.com or by calling NIA Magellan at 800-642-7543.

For complete information, please refer to the updated CT Screening for Lung Cancer Medical Policy.

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    HPHCURRENT EVENTS

    New Opioid Safety Edits for Medicare and Commercial Plans

    CLINICIAN CORNER

    Update: New Coding for CT Screening for Lung Cancer

    Updates to Reimbursement for Moderate Sedation Services

    Harvard Pilgrim Will Cover Screening 3D Mammography in Connecticut

    Massachusetts Standard Form for Medication Prior Authorization Requests

    Updates to Prior Authorization Policy for Ilaris

    Medicare Prescriber Enrollment Deadline Updated

    Harvard Pilgrim Preferred Insulin Products on the Value Formulary

    Depression Screening and Potential Side Effects of Antidepressants

    OFFICE ASSISTANT

    Keep Panel Status and Demographic Information Up to Date

    PUBLICATION INFORMATION

    Eric H. Schultz,
    President and Chief Executive Officer

    Robert Farias,
    Vice President, Network Services

    Annmarie Dadoly,
    Editor

    Joseph O'Riordan,
    Writer

    Kristin Edmonston,
    Production Coordinator