Asuris Medicare Advantage and its affiliated Plans use medical policies as guidelines for coverage decisions within the member’s written benefits. Below are summaries of recent changes to the Medicare Advantage medical policy manual. We have included the section and policy number for your convenience.
The complete Medicare Medical Policy Manual with detailed policies are available online at https://www.asuris.com/provider/library/policies-guidelines/medical-policy/ma-medical-policy.
Policy name | Summary of policy or change | Effective date | Section and policy number |
|---|---|---|---|
New Medicare Advantage medical policy will rely on commercial policy guidance. | November 1, 2025 | Surgery #M-17 | |
Updated the policy to remove four codes and add to:
| September 1, 2025 | Medicine #M-149 | |
New Medicare Advantage medical policy addressing Histotripsy for Hepatic or Renal Tumor Treatment. | September 1, 2025 | Medicine #M-178 | |
New Medicare Advantage medical policy addressing Travoprost Drug-eluting Ocular Implants for the Treatment of Glaucoma. | September 1, 2025 | Surgery #M-237 | |
Added a new National Coverage Analysis (NCA) for ventilators in the home related to chronic obstructive pulmonary disease. | August 1, 2025 | Durable Medical Equipment #M-87 | |
Removed 2 codes.
| August 1, 2025 | Medicine #M-149 | |
Removed retired article A51751 and changed review to the commercial policy guidance. | August 1, 2025 | Surgery #M-111 | |
| July 1, 2025 | Genetic Testing #M-64 | |
Updated the policy in alignment with the 2025 Q3 code update and updated Medicare guidance. | July 1, 2025 | Genetic Testing #M-83 | |
Updated Medicare guidance for Implanted Pulmonary Artery Pressure Sensor for Heart Failure Management from a decision memo to a new National Coverage Determination (NCD). | July 1, 2025 | Medicine #M-33 | |
| July 1, 2025 | Medicine #M-149 | |
New policy to address electromagnetic navigation bronchoscopy. | July 1, 2025 | Surgery #M-179 | |
New policy will rely on commercial policy guidance. | July 1, 2025 | Surgery #M-239 | |
New policy will rely on commercial policy guidance. | July 1, 2025 | Surgery #M-240 | |
Expanding post-service review of rotary air ambulance. | July 1, 2025 | Utilization Management #M-13 | |
Updated guidance for Vistaseq panels. | June 1, 2025 | Genetic Testing #M-02 | |
Clarified that policy does not address preparatory prostheses. | May 1, 2025 | Durable Medical Equipment #M-18 | |
Updated policy with new Medicare correct coding and billing article for lymphedema compression garments. | May 1, 2025 | Durable Medical Equipment #M-92 | |
Removed reference to LCD Skin Substitute Grafts for Diabetic Foot and Venous Leg Ulcers, as this LCD now has an effective date of 1/1/2026. | May 1, 2025 | Medicine #M-170 | |
Added Medicare guidance for disposable negative pressure wound therapy devices and care. | April 1, 2025 | Durable Medical Equipment #M-42 | |
New policy for mechanical residual limb volume management systems (e.g., RevoFit) for upper extremity prostheses. | April 1, 2025 | Durable Medical Equipment #M-98 | |
Revised to align with the 2025 Q2 code update and updated Medicare guidance. | April 1, 2025 | Genetic Testing #M-64 | |
Revised to align with the 2025 Q2 code update and updated Medicare guidance. | April 1, 2025 | Genetic Testing #M-83 | |
Revised to align with the 2025 Q2 code update. | April 1, 2025 | Medicine #M-149 | |
Adding new LCD (L39812) and Article (A59697) addressing minimally invasive sacroiliac joint fusion. | April 1, 2025 | Surgery #M-193 | |
Updated criteria to use commercial policy for TYMS testing in the health plan service area. | March 1, 2025 | Laboratory #M-64 |
Policy name | Archive date | Medicare Manual section and policy # |
|---|---|---|
Signal-Averaged Electrocardiography (SAECG) | July 1, 2025 | Medicine #M-21 |
Extracorporeal Membrane Oxygenation (ECMO) for the Treatment of Cardiac and Respiratory Failure in Adults | June 1, 2025 | Medicine #M-152 |