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

July 2014

Update of Cardiovascular Disease Risk Tests Policy 


Harvard Pilgrim covers high sensitivity C-reactive protein testing to assess cardiovascular disease risk for certain members. Our Cardiovascular Disease Risk Tests Medical Policy details the coverage criteria and lists the tests that are not covered for risk assessment because Harvard Pilgrim considers them experimental/investigational or unproven due to inadequate support in the clinical literature.

Based on an ongoing review of the clinical literature to determine medical necessity, Harvard Pilgrim is updating this policy to include cystatin c (82610) and fibrinogen antigen (83585) among the uncovered tests, effective October 1, 2014. Please refer to the Cardiovascular Disease Risk Tests Medical Policy for more information.

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CLINICIAN CORNER

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Prior Authorization Required for Hyaluronate Injections for Osteoarthritis

Update of Cardiovascular Disease Risk Tests Policy

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OFFICE ASSISTANT

Update: Durable Medical Equipment Payment Policy

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,
Editor

Kristin Edmonston,
Production Coordinator