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

July 2015

Highlights

ICD-10 Information Available Online

In preparation for the upcoming move from ICD-9 to ICD-10 code sets, Harvard Pilgrim has developed an FAQ to answer questions that providers may have as the compliance date draws near, including topics such as the submission of claims; notifications, referrals, and authorizations; provider self-testing options; and key resources for additional information.

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Genetic Testing Medical Policy Updated

Harvard Pilgrim covers genetic testing for certain members when it is deemed medically necessary.

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Update: Outpatient Rehabilitative Therapies Policy

Harvard Pilgrim recently updated our Outpatient Rehabilitative Therapies Notification and Authorization Policy for greater clarity.

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Acute Pain Management and Safe Opioid Prescribing

With opioid addiction and overdose deaths rising in the area, the safe and appropriate use of opioids to manage pain is an important topic in health care.

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Vivitrol as Part of a Substance Abuse Treatment Plan

Harvard Pilgrim would like to remind providers who have prescribed Vivitrol of the importance of combining this medication with behavioral health support and counseling, as well as follow-up communication with behavioral health providers to gauge patient adherence to the treatment plan.

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HPHCURRENT EVENTS

ICD-10 Information Available Online

Reminder: Now Offering GIC POS and HMO Products

CLINICIAN CORNER

Genetic Testing Medical Policy Updated

New Medical Policy for Urine Drug Testing

Coverage of Oral Devices for Obstructive Sleep Disorder

Update: Outpatient Rehabilitative Therapies Policy

Acute Pain Management and Safe Opioid Prescribing

Reminder: Naloxone Available Without Member Cost Sharing

Vivitrol as Part of a Substance Abuse Treatment Plan

P&T Committee Updates

Specialty Pharmacy Program Updates

Medicare Quality Improvement: Reducing Preventable Readmissions

Diabetes Outreach Program for Medicare Advantage Members

OFFICE ASSISTANT

Payment Policy Update: Coverage of CPT 99211

Payment Policy Update: Counseling Risk Factor Reduction

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