All PlansCoverageHigh impact
Medical Policy and Coding Updates - February 2020
Premera Blue Cross·WA · Orthopedics, General Surgery, Plastic Surgery +3 more·Medical Policy
Effective date
Mar 4, 2020
We identified it
Jun 18, 2026
Summary
Multiple policy changes effective between March 4, 2020 and July 2, 2020, including transition to InterQual criteria for surgical procedures, updates to drug biosimilar preferences, and revised clinical appropriateness guidelines for radiology and genetic testing.
Action Required
By July 2, 2020: Billing team must access provider website to review new InterQual criteria for bariatric surgery, joint replacement, and cosmetic procedures as these replace existing medical policies. Update prior authorization processes for affected procedures. Before March 4, 2020: Review AIM Specialty Health guidelines for radiology and genetic testing to ensure compliance with updated appropriateness criteria. Verify biosimilar drug preferences are updated in billing system for oncology medications.