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Policies and Protocols for Healthcare Providers
Commercial Policy Benefits Plans for Providers
UnitedHealthcare® Oxford Clinical and Administrative Policies
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Dental Clinical Policies and Coverage Guidelines
Medical & Drug Policies and Coverage Determination Guidelines for UnitedHealthcare Commercial Plans
Reimbursement Policies for UnitedHealthcare Commercial Plans
UnitedHealthcare West Benefit Interpretation Policies
UnitedHealthcare West Medical Management Guidelines
The Clinical Policies, Administrative Policies, and corresponding update bulletins for UnitedHealthcare Oxford plans are listed below.
To view applicable Medical Benefit Drug Policies, click here.
To view applicable Reimbursement Policies, click here.
Policy Update Bulletins
A monthly notice of recently approved and/or revised Clinical and Administrative Policies is provided below for your review. We publish a new announcement on the first calendar day of every month.
The appearance of a health service (e.g., test, drug, device or procedure) in the Policy Update Bulletin does not imply that UnitedHealthcare provides coverage for the health service. In the event of an inconsistency or conflict between the information provided in the Policy Update Bulletin and the posted policy, the provisions of the posted policy will prevail.
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07/01/2022 – Oxford Policy Update Bulletin: July 2022
Last Published 07.01.2022
This bulletin provides complete details on recently approved, revised, and/or retired UnitedHealthcare Oxford Clinical, Administrative and Reimbursement Policies.
08/01/2022 - Oxford Policy Update Bulletin: August 2022
09/01/2022 - Oxford Policy Update Bulletin: September 2022
Oxford Policy Update Bulletin Archive
A listing of the Oxford Policy Update Bulletins for the past two rolling years.
Current Policies
Please read the terms and conditions below carefully.
A complete library of the UnitedHealthcare® Oxford Clinical and Administrative Policies is available here for your reference. The appearance of an item or procedure on the list indicates only that we have adopted a policy; it does not imply that we provide coverage for the item or procedure listed.
The services described in our policies are subject to the terms, conditions and limitations of the member's contract or certificate. We reserve the right, in our sole discretion, to modify policies as necessary without prior written notice unless otherwise required by our administrative procedures or applicable state law. The terms "our" and "we" include Oxford Health Plans, LLC and all of its subsidiaries as appropriate for these policies.
Certain policies may not be applicable to self-funded members and certain insured products. Refer to the member's plan of benefits or Certificate of Coverage to determine whether coverage is provided or if there are any exclusions or benefit limitations applicable to any of these policies. If there is a difference between any policy and the member's plan of benefits or Certificate of Coverage, the plan of benefits or Certificate of Coverage will govern.
By clicking "I Agree," you agree to be bound by the terms and conditions expressed herein, in addition to our Site Use Agreement.
Ablative Treatment for Spinal Pain – Oxford Clinical Policy
Effective Date: 03.01.2022 – This policy addresses conventional thermal radiofrequency ablation and other facet joint nerve ablation procedures for spinal pain. Applicable Procedure Codes: 22899, 27299, 64625, 64628, 64629, 64633, 64634, 64635, 64636, 64999.
Abnormal Uterine Bleeding and Uterine Fibroids – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses the use of levonorgestrel-releasing intrauterine devices (LNG-IUD), uterine artery embolization (UAE), magnetic resonance-guided focused ultrasound ablation (MRgFUS), and ultrasound-guided radiofrequency ablation. Applicable Procedure Codes: 0071T, 0072T, 0404T, 37243, 58674, J7296, J7297, J7298, J7301, J7306, S4981.
Abortions (Therapeutic and Elective) – Oxford Administrative Policy
Effective Date: 01.01.2022 – This policy addresses therapeutic and elective abortions. Applicable Procedure Codes: 59100, 59120, 59121, 59130, 59136, 59140, 59150, 59151, 59812, 59820, 59821, 59830, 59840, 59841, 59850, 59851, 59852, 59855, 59856, 59857, 59866, 59870, S0199, S2260, S2265, S2266, S2267.
Accreditation Requirements for Radiology Services - Oxford Administrative Policy
Effective Date: 11.01.2021 – This policy addresses accreditation requirements for radiologists, radiology centers, and multi-speciality provider groups interested in participating in the UnitedHealthcare Oxford network.
Acquired Rare Disease Drug Therapy Exception Process – Oxford Administrative Policy
Effective Date: 12.01.2021 – This policy addresses the exception process for the experimental/investigational treatment (drug therapy) of an acquired rare disease.
Airway Clearance Devices – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses airway clearance devices, such as high-frequency chest wall oscillation systems, and intrapulmonary percussive ventilation (IPV) devices. Applicable Procedure Codes: A7025, A7026, E0481, E0483.
Ambulance Services – Oxford Administrative Policy
Effective Date: 07.01.2022 – This policy addresses emergency ambulance (ground, water, or air) and non-emergency ambulance (ground or air) services.
"A0225, A0380, A0382, A0384, A0390, A0392, A0394, A0396, A0398, A0420, A0422, A0424, A0425, A0426, A0427, A0428, A0429, A0430, A0431, A0432, A0433, A0434, A0435, A0436, A0998, A0999, S0207, S0208, S9960, S9961, T2007"
Apheresis – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses apheresis/therapeutic apheresis. Applicable Procedure Codes: 0342T, 36511, 36512, 36513, 36514, 36516, 36522, S2120.
Articular Cartilage Defect Repairs – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses autologous chondrocyte transplantation (ACT), osteochondral autograft and allograft transplantation, microfracture repair of the knee, and focal articular cartilage repair. Applicable Procedure Codes: 27412, 27415, 27416, 28446, 29866, 29867, 29879, J7330, S2112.
Athletic Pubalgia Surgery - Oxford Clinical Policy
Effective Date: 07.01.2021 – This policy addresses surgical repair for treating athletic pubalgia. Applicable Procedure Codes: 49659, 49999.
Attended Polysomnography for Evaluation of Sleep Disorders – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses home sleep apnea testing, attended full-channel nocturnal polysomnography performed in a healthcare facility or laboratory setting, daytime sleep studies, and attended PAP titration. Applicable Procedure Codes: 95782, 95783, 95800, 95801, 95803, 95805, 95806, 95807, 95808, 95810, 95811, G0398, G0399, G0400.
Autism Spectrum Disorder and Developmental Disabilities - Oxford Administrative Policy
Effective Date: 11.01.2021 – This policy addresses services for the treatment of autism spectrum disorder and developmental disabilities.
No procedure codes in policy (only ICD-10 dx)
Autologous Cellular Therapy – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses autologous cellular therapy. Applicable Procedures Codes: 0263T, 0264T, 0265T, 0489T, 0490T, 0565T, 0566T, 0717T, 0718T, 27599.
Balloon Sinus Ostial Dilation - Oxford Clinical Policy
Effective Date: 08.01.2021 – This policy addresses balloon sinus ostial dilation. Applicable Procedure Codes: 31295, 31296, 31297, 31298, 31299.
Bariatric Surgery – Oxford Clinical Policy
Effective Date: 05.01.2022 – This policy addresses bariatric surgical procedures. Applicable Procedure Codes: 0312T, 0313T, 0314T, 0315T, 0316T, 0317T, 43644, 43645, 43647, 43648, 43659, 43770, 43771, 43772, 43773, 43774, 43775, 43842, 43843, 43845, 43846, 43847, 43848, 43860, 43865, 43881, 43882, 43886, 43887, 43888, 43999, 64590, 64595
Beds and Mattresses – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses hospital beds, mattresses, and accessories. Applicable Procedure Codes: E0193, E0194, E0250, E0251, E0255, E0256, E0260, E0261, E0265, E0266, E0271, E0272, E0273, E0274, E0277, E0280, E0290, E0291, E0292, E0293, E0294, E0295, E0296, E0297, E0300, E0301, E0302, E0303, E0304, E0305, E0310, E0315, E0316, E0328, E0329, E0910, E0911, E0912, E0940.
Behavioral Health Services – Oxford Administrative Policy
Effective Date: 10.01.2021 – This policy addresses behavioral health services for the treatment of mental health and substance use disorders.
Blepharoplasty, Blepharoptosis, and Brow Ptosis Repair - Oxford Clinical Policy
Effective Date: 04.01.2021 – This policy addresses upper and lower eyelid blepharoplasty, upper eyelid blepharoptosis repair, brow ptosis, eyelid surgery with an anophthalmic socket, ectropion or punctal eversion, entropion, lid retraction surgery, canthoplasty/canthopexy, and repair of floppy eyelid syndrome (FES).
15820, 15821, 15822, 15823, 21280, 21282, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67911, 67912, 67914, 67915, 67916, 67917, 67921, 67922, 67923, 67924, 67950, 67961, 67966
Breast Imaging for Screening and Diagnosing Cancer – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses breast imaging, including digital mammography, magnetic resonance imaging (MRI), ultrasound, automated breast ultrasound system, computer-aided detection (CAD), computer-aided tactile breast imaging, electrical impedance scanning (EIS), magnetic resonance elastography (MRE), and molecular breast imaging. Applicable Procedure Codes: 0422T, 0633T, 0634T, 0635T, 0636T, 0637T, 0638T, 76376, 76377, 76391, 76498, 76499, 76641, 76642, 77046, 77047, 77048, 77049, 77065, 77066, 77067, S8080.
Breast Reconstruction Post Mastectomy and Poland Syndrome - Oxford Clinical Policy
Effective Date: 11.01.2021 – This policy addresses breast reconstruction post-mastectomy and for treatment of Poland syndrome. Applicable Procedure Codes: 11920, 11921, 11922, 11970, 11971, 15271, 15272, 15771, 15772, 15777, 19301, 19302, 19303, 19305, 19306, 19307, 19316, 19318, 19325, 19330, 19340, 19342, 19350, 19355, 19357, 19361, 19364, 19367, 19368, 19369, 19380, 19396, 19499, L8600, S2066, S2067, S2068, S8950.
Breast Reduction Surgery – Oxford Clinical Policy
Effective Date: 05.01.2021 – This policy addresses breast reduction surgeries. Applicable Procedure Code: 19318.
Breast Repair/Reconstruction Not Following Mastectomy – Oxford Clinical Policy
Effective Date: 12.01.2021 – This policy addresses breast repair/reconstruction not following mastectomy. Applicable Procedure Codes: 19328, 19330, 19355, 19370, 19371, 19380.
Bronchial Thermoplasty - Oxford Clinical Policy
Effective Date: 08.01.2021 – This policy addresses bronchial thermoplasty. Applicable Procedure Codes: 31660, 31661.
Cardiac Event Monitoring – Oxford Clinical Policy
Effective Date: 04.01.2022 – This policy addresses cardiac event monitoring, including ambulatory event monitoring, outpatient cardiac telemetry, and implantable loop recorder. Applicable Procedure Codes: 0650T, 33285, 33286, 93224, 93225, 93226, 93227, 93228, 93229, 93241, 93242, 93243, 93244, 93245, 93246, 93247, 93248, 93268, 93270, 93271, 93272, 93285, 93291, 93298, E0616, G2066.
Cardiology Procedures Requiring Prior Authorization for eviCore healthcare Arrangement – Oxford Clinical Policy
Effective Date: 04.01.2022 – This policy addresses cardiology procedures requiring precertification with initial review performed by eviCore healthcare.
"0501T, 0502T, 0503T, 0504T, 0571T, 0614T, 33289, 75557, 75559, 75561, 75563, 75565, 75571, 75572, 75573, 75574, 78451, 78452, 78453, 78454, 78459, 78491, 78492, 93303, 93304, 93306, 93307, 93308, 93350, 93351, 93451, 93452, 93453, 93454, 93455, 93456, 93457, 93458, 93459, 93460, 93461, 93462, 93452, 93453, 93454, 93455, 93456, 93457, 93458, 93459, 93460, 93461, 93303, 93304, 93306, 93307, 93308, 93350, 93351, C9762, C9763"
Cardiovascular Disease Risk Tests – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses arterial compliance testing using waveform analysis, carotid intima-media thickness (CIMT) measurement, advanced lipoprotein analysis, endothelial function assessment, and tests for lipoprotein-associated phospholipase A2 (Lp-PLA2) enzyme, other human A2 phospholipases, and long-chain omega-3 fatty acids. Applicable Procedure Codes: 0052U, 0308U, 0309U, 0423T, 82172, 83695, 83698, 83701, 83704, 93050, 93799, 93895, 93998.
Carrier Testing for Genetic Diseases - Oxford Clinical Policy
Effective Date: 09.01.2021 – This policy addresses the Ashkenazi Jewish carrier screening and expanded carrier screening panel testing. Applicable Procedure Codes: 81412, 81443, 81479.
Catheter Ablation for Atrial Fibrillation – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses catheter ablation for atrial fibrillation. Applicable Procedure Codes: 93653, 93655, 93656, 93657.
Cell-Free Fetal DNA Testing – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses DNA-based noninvasive prenatal tests. Applicable Procedure Codes: 0060U, 0327U, 81420, 81422, 81479, 81507.
Chelation Therapy for Non-Overload Conditions - Oxford Clinical Policy
Effective Date: 05.01.2021 – This policy addresses chelation therapy. Applicable Procedure Codes: J0470, J0600, J0895, J3490, J8499, M0300, S9355.
Chromosome Microarray Testing (Non-Oncology Conditions) – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses genome-wide comparative genomic hybridization microarray testing or single nucleotide polymorphism (SNP) chromosomal microarray analysis. Applicable Procedure Codes: 0156U, 0209U, 81228, 81229, 81349, 81479, S3870.
Clinical Trials - Oxford Clinical Policy
Effective Date: 05.01.2021 – This policy addresses clinical trials. Applicable Procedure Codes: G0276, G0293, G0294, G2000, S9988, S9990, S9991, S9992, S9994, S9996.
Cochlear Implants – Oxford Clinical Policy
Effective Date: 07.01.2021 – This policy addresses non-hybrid and hybrid cochlear implantation. Applicable Procedure Codes: 69930, L8614, L8615, L8616, L8617, L8618, L8619, L8627, L8628, V5273.
Collagen Crosslinks and Biochemical Markers of Bone Turnover – Oxford Clinical Policy
Effective Date: 04.01.2022 – This policy addresses serum or urine collagen crosslinks or biochemical markers. Applicable Procedure Code: 82523.
Comprehensive and Component CPT Codes – Oxford Administrative Policy
Effective Date: 01.01.2022 – This policy addresses the payment methodology utilized by Oxford for claims determinations when multiple procedures are performed in the same session by the same provider.
Computer-Assisted Surgical Navigation for Musculoskeletal Procedures - Oxford Clinical Policy
Effective Date: 10.01.2021 – This policy addresses computer-assisted surgical navigation for musculoskeletal procedures and the use of intra-operative kinetic balance sensor for implant stability during knee replacement arthroplasty. Applicable Procedures Codes: 0054T, 0055T, 20985.
Computerized Dynamic Posturography - Oxford Clinical Policy
Effective Date: 05.01.2021 – This policy addresses computerized dynamic posturography (CDP) testing. Applicable Procedure Codes: 92548, 92549.
Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses insulin delivery and continuous glucose monitoring for diabetes management. Applicable Procedure Codes: 0446T, 0447T, 0448T, 95249, 95250, 95251, A4211, A4226, A4238, A9274, A9276, A9277, A9278, E0784, E0787, E1399, E2102, G0308, G0309, K0553, K0554, S1030, S1031, S1034, S1035, S1036, S1037.
Contraceptives – Oxford Administrative Policy
Effective Date: 08.01.2022 – This policy addresses contraceptive procedures/appliances/devices and injectable drugs provided in a physician's office.
Core Decompression for Avascular Necrosis - Oxford Clinical Policy
Effective Date: 12.01.2021 – This policy addresses core decompression for avascular necrosis. Applicable Procedure Codes: 21299, 23929, 27299, 27599, 27899, S2325.
Corneal Hysteresis and Intraocular Pressure Measurement - Oxford Clinical Policy
Effective Date: 08.01.2021 – This policy addresses measurement of corneal hysteresis, measurement of ocular blood flow, and monitoring of intraocular pressure. Applicable Procedure Codes: 0198T, 0329T, 66999, 67299, 92145.
Cosmetic and Reconstructive Procedures – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses cosmetic and reconstructive procedures.
"11920, 11921, 11922, 11960, 14000, 14001, 14020, 14021, 14040, 14041, 14060, 14061, 14301, 14302, 15570, 15572, 15574, 15730, 15731, 15733, 15734, 15736, 15738, 15740, 15756, 15769, 15771, 15772, 15773, 15774, 17999, 19316, 19325, 21137, 21138, 21139, 21172, 21175, 21179, 21180, 21181, 21182, 21183, 21184, 21208, 21209, 21230, 21235, 21248, 21249, 21255, 21256, 21260, 21261, 21263, 21267, 21268, 21275, 21295, 21296, 21299, 28344, 30540, 30545, 30560, 30620, 11950, 11951, 11952, 11954, 15775, 15776, 15780, 15781, 15782, 15783, 15786, 15787,15788, 15789, 15792 , 15793, 15819, 15824, 15825, 15826, 15828, 15829, 17380, 21270, 69090, 69300, 36468, 36470, 36471, J0591, L8600, L8607, Q2026, Q2028"
Credentialing Guidelines: Participation in the eviCore healthcare Network - Oxford Administrative Policy
Effective Date: 11.01.2021 – This policy addresses credentialing guidelines for radiologists and cardiologists interested in participating in the eviCore healthcare network.
Cytological Examination of Breast Fluids for Cancer Screening or Diagnosis - Oxford Clinical Policy
Effective Date: 09.01.2021 – This policy addresses breast ductal lavage, breast ductal fluid aspiration and cytology, and fiberoptic ductoscopy with or without ductal lavage. Applicable Procedure Code: 19499.
Deep Brain and Cortical Stimulation – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses deep brain stimulation and responsive cortical stimulation. Applicable Procedure Codes: 61850, 61860, 61863, 61864, 61867, 61868, 61885, 61886, 64999, L8679, L8680, L8682, L8685, L8686, L8687, L8688.
Dental and Oral Surgical Procedures – Oxford Administrative Policy
Effective Date: 07.01.2022 – This policy addresses oral surgical and dental procedures and related anesthesia when determined to be medical in nature.
Diabetes Supply Coverage - Oxford Administrative Policy
Effective Date: 06.01.2021 – This policy addresses supplies, medications, and equipment for the treatment of diabetes.
A4206, A4210, A4212, A4215, A4225, A4230, A4231, A4232, A4233, A4234, A4235, A4236, A4244, A4245, A4250, A4252, A4253, A4255, A4256, A4258, A4259, A6257, A9274, A9275, E0607, E2100, E2101, J1610, J1815, J1817, J3490, K0601, K0602, K0603, K0604, K0605, S5550, S5551, S5552, S5553, S5560, S5561, S5565, S5566, S5570, S5571, S8490
Dialysis Services – Oxford Administrative Policy
Effective Date: 03.01.2022 – This policy addresses dialysis services. Applicable Procedure Codes: 90935, 90937, 90945, 90947, 90951, 90952, 90953, 90954, 90955, 90956, 90957, 90958, 90959, 90960, 90961, 90962, 90967, 90968, 90969, 90970, 90989, 90993, 90997, 90999, G0257, G0491, G0492.
Disclosure Policy – Oxford Administrative Policy
Effective Date: 09.01.2020 – This policy addresses certain information disclosed to members regarding their claims for benefits covered under their certificates or appeals of adverse benefit determinations.
Discogenic Pain Treatment – Oxford Clinical Policy
Effective Date: 03.01.2022 – This policy addresses annular closure devices (ACDs), percutaneous injection of allogeneic cellular/tissue-based products, percutaneous discectomy and decompression procedures, and thermal intradiscal procedures (TIPs) for treating discogenic pain. Applicable Procedure Codes: 0627T, 0628T, 0629T, 0630T, 22526, 22527, 22899, 62287, 62380, S2348.
Durable Medical Equipment, Orthotics, Medical Supplies and Repairs/Replacements – Oxford Administrative Policy
Effective Date: 03.01.2022 – This policy addresses durable medical equipment (DME), orthotics, ostomy supplies, medical supplies and repairs/replacements.
Elective Inpatient Services – Oxford Clinical Policy
Effective Date: 05.01.2022 – This policy addresses planned elective inpatient admission for certain surgeries or procedures.
Electric Tumor Treatment Field Therapy - Oxford Clinical Policy
Effective Date: 11.01.2021 – This policy addresses the use of devices to generate electric tumor treatment fields (TTF). Applicable Procedure Codes: 77299, A4555, E0766.
Electrical and Ultrasound Bone Growth Stimulators – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses electrical and ultrasonic bone growth stimulators. Applicable Procedure Codes: 20974, 20975, 20979, E0747, E0748, E0749, E0760.
Electrical Bioimpedance for Cardiac Output Measurement - Oxford Clinical Policy
Effective Date: 09.01.2021 – This policy addresses electrical bioimpedance for cardiac output measurement. Applicable Procedure Code: 93701.
Electrical Stimulation and Electromagnetic Therapy for Wounds – Oxford Clinical Policy
Effective Date: 04.01.2022 – This policy addresses electrical stimulation and electromagnetic therapy for wounds. Applicable Procedure Codes: E0769, G0281, G0282, G0295, G0329.
Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses electrical stimulation for the treatment of pain and muscle rehabilitation. Applicable Procedure Codes: 0278T, 0720T, 63650, 63655, 63663, 63664, 63685, 64555, 64999, E0744, E0745, E0762, E0764, E0770, E1399, L8679, L8680, L8682, L8685, L8686, L8687, L8688, S8130, S8131.
Embolization of the Ovarian and Iliac Veins for Pelvic Congestion Syndrome – Oxford Clinical Policy
Effective Date: 05.01.2022 – This policy addresses embolization of the ovarian or internal iliac veins. Applicable Procedure Code: 37241.
Epidural Steroid Injections for Spinal Pain – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses epidural steroid injections for spinal pain. Applicable Procedure Codes: 62320, 62321, 62322, 62323, 64479, 64480, 64483, 64484.
Epiduroscopy, Epidural Lysis of Adhesions and Discography – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses functional anesthetic discography (FAD), provocative discography, epiduroscopy (including spinal myeloscopy), and percutaneous and endoscopic epidural lysis of adhesions for the diagnosis or treatment of any type of neck, back, or spinal disorder. Applicable Procedure Codes: 62263, 62264, 62290, 62291, 62292, 64999, 72285, 72295.
Experimental/Investigational Treatment for NJ Plans – Oxford Administrative Policy
Effective Date: 12.01.2021 – This policy addresses experimental and/or investigational treatment or procedures for New Jersey (NJ) Plans.
Experimental/Investigational Treatment – Oxford Administrative Policy
Effective Date: 12.01.2021 – This policy addresses experimental and/or investigational treatment or procedures.
Extended Benefits for Total Disability & Succeeding Carrier for Inpatient Admissions – Oxford Administrative Policy
Effective Date: 10.01.2021 – This policy addresses extended benefits for totally disabled members, including when a member changes carriers while confined in an inpatient facility.
Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions and Soft Tissue Wounds – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses extracorporeal shock wave therapy (ESWT) for musculoskeletal and soft tissue conditions. Applicable Procedure Codes: 0101T, 0102T, 0512T, 0513T, 28890.
Facet Joint and Medial Branch Block Injections for Spinal Pain – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses facet joint injections/medial branch blocks for spinal pain. Applicable Procedure Codes: 0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 64490, 64491, 64492, 64493, 64494, 64495.
Fecal Calprotectin Testing – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses fecal measurement of calprotectin. Applicable Procedure Code: 83993.
Fertility Preservation for Iatrogenic Infertility – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses fertility preservation for medical reasons that cause irreversible infertility. Applicable Procedure Codes: 58970, 89250, 89251, 89253, 89254, 89258, 89259, 89260, 89261, 89264, 89268, 89272, 89280, 89281, 89320, 89337, 89342, 89343, 89346, S0122, S0126, S0128, S0132, S4011, S4022, S4027, S4030, S4031, S4040, J0725, J3355.
Follow-Up Care Rendered in an Emergency Room Site of Service – Oxford Administrative Policy
Effective Date: 07.01.2022 – This policy addresses follow-up care when rendered in an emergency room (ER) site of service/setting.
Formula and Specialized Food – Oxford Administrative Policy
Effective Date: 04.01.2022 – This policy addresses specialized formula and foods, including enteral formulas, nutritional formulas, and pasteurized donor human milk. Applicable Procedure Codes: B4100, B4102, B4103, B4104, B4149, B4150, B4152, B4153, B4154, B4155, B4157, B4158, B4159, B4160, B4161, B4162, S9432, S9433, S9434, S9435, T2101.
Functional Endoscopic Sinus Surgery (FESS) – Oxford Clinical Policy
Effective Date: 04.01.2022 – This policy addresses functional endoscopic sinus surgery (FESS). Applicable Procedure Codes: 31240, 31253, 31254, 31255, 31256, 31257, 31259, 31267, 31276, 31287, 31288.
Gastrointestinal Motility Disorders, Diagnosis and Treatment - Oxford Clinical Policy
Effective Date: 07.01.2021 – This policy addresses gastric electrical stimulation therapy; manometry, sensation, tone, and compliance testing; defecography; and electrogastrography/electroenterography. Applicable Procedure Codes: 43647, 43648, 43881, 43882, 64590, 64595, 72195, 72196, 72197, 76496, 91117, 91120, 91122, 91132, 91133.
Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing for Infectious Diarrhea – Oxford Clinical Policy
Effective Date: 04.01.2022 – This policy addresses multiplex polymerase chain reaction (PCR) panel testing of gastrointestinal pathogens. Applicable Procedure Codes: 87505, 87506, 87507.
Gender Dysphoria Treatment – Oxford Clinical Policy
Effective Date: 10.01.2021 – This policy addresses gender dysphoria treatment, including surgical treatment and certain ancillary procedures.
"11950, 11951, 11952, 11954, 14000, 14001, 14041, 15734, 15738, 15750, 15757, 15758, 15769, 15771, 15772, 15773, 15774, 15775, 15776, 15780, 15781, 15782, 15783, 15788, 15789, 15792, 15793, 15819, 15820, 15821, 15822, 15823, 15824, 15825, 15826, 15828, 15829, 15830, 15832, 15833, 15834, 15835, 15836, 15837, 15838, 15839, 15847, 15876, 15877, 15878, 15879, 17380, 17999, 19303, 19316, 19318, 19325, 19340, 19342, 19350, 21120, 21121, 21122, 21123, 21125, 21127, 21137, 21138, 21139, 21172, 21175, 21179, 21180, 21208, 21209, 21210, 21270, 21899, 30400, 30410, 30420, 30430, 30435, 30450, 31599, 31899, 53410, 53430, 54125, 54400, 54401, 54405, 54406, 54408, 54410, 54411, 54415, 54416, 54417, 54520, 54660, 54690, 55175, 55180, 55970, 55980, 56625, 56800, 56805, 57110, 57335, 58150, 58180, 58260, 58262, 58290, 58291, 58541, 58542, 58543, 58544, 58550, 58552, 58553, 58554, 58570, 58571, 58572, 58573, 58661, 58720, 58940, 64856, 64892, 64896, 67900, 92507, 92508"
Genetic Testing for Cardiac Disease - Oxford Clinical Policy
Effective Date: 07.01.2021 – This policy addresses genetic testing for cardiac disease. Applicable Procedure Codes: 0237U, 81410, 81411, 81413, 81414, 81439, 81479, 81493.
Genetic Testing for Hereditary Cancer – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses hereditary breast and ovarian cancer (BRCA1, BRCA2) testing and multi-gene hereditary cancer panel testing.
"0101U, 0102U, 0103U, 0129U, 0130U, 0131U, 0132U, 0133U, 0134U, 0135U, 0138U, 0162U, 0238U, 81162, 81163, 81164, 81165, 81166, 81167, 81216, 81432, 81433, 81435, 81436, 81437, 81438"
Genetic Testing for Neuromuscular Disorders - Oxford Clinical Policy
Effective Date: 10.01.2021 – This policy addresses multi-gene panel testing for the diagnosis of neuromuscular disorders. Applicable Procedure Codes: 0216U, 0217U, 81440, 81460, 81465, 81479.
Genitourinary Pathogen Nucleic Acid Detection Panel Testing – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses genitourinary pathogen nucleic acid detection panel testing to evaluate symptomatic women for vaginitis. Applicable Procedure Codes: 0068U, 0330U, 87480, 81513, 81514, 87481, 87482, 87510, 87511, 87512, 87660, 87661, 87797, 87798, 87799, 87800, 87801.
Glaucoma Surgical Treatments – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses glaucoma drainage devices/stents, canaloplasty, and gonioscopy-assisted transluminal trabeculotomy. Applicable Procedure Codes: 0253T, 0449T, 0450T, 0474T, 0671T, 65820, 66174, 66175, 66179, 66180, 66183, 66184, 66185, 66989, 66991, C1889, L8612.
Gynecomastia Treatment – Oxford Clinical Policy
Effective Date: 05.01.2021 – This policy addresses mastectomy or suction lipectomy for the treatment of benign gynecomastia. Applicable Procedure Code: 19300.
Hearing Aids and Devices Including Wearable, Bone-Anchored and Semi-Implantable – Oxford Clinical Policy
Effective Date: 03.01.2022 – This policy addresses wearable air conduction, bone-anchored, semi-implantable hearing aids (SEHA), intraoral bone conduction, and laser or light based hearing aids, and totally implanted middle ear hearing systems.
Home Health Care – Oxford Clinical Policy
Effective Date: 08.01.2021 – This policy addresses home health care services.
"99500, 99501, 99502, 99503, 99504, 99505, 99506, 99507, 99511, 99512, 99601, 99602, G0068, G0069, G0070, G0088, G0089, G0090, G0151, G0152, G0153, G0155, G0156, G0157, G0158, G0159, G0160, G0161, G0162, G0299, G0300, G0490, G0493, G0494, G0495, G0496, G2168, G2169, H1004, S5035, S5036, S5108, S5109, S5110, S5111, S5115, S5116, S5180, S5181, S5497, S5498, S5501, S5502, S5517, S5518, S5520, S5521, S5522, S5523, S9061, S9097, S9098, S9122, S9123, S9124, S9127, S9128, S9129, S9131, S9208, S9209, S9211, S9212, S9213, S9214, S9325, S9326, S9327, S9328, S9329, S9330, S9331, S9335, S9336, S9338, S9339, S9340, S9341, S9342, S9343, S9345, S9346, S9347, S9348, S9351, S9353, S9355, S9357, S9359, S9361, S9363, S9364, S9365, S9366, S9367, S9368, S9370, S9372, S9373, S9374, S9375, S9376, S9377, S9379, S9474, S9490, S9494, S9497, S9500, S9501, S9502, S9503, S9504, S9537, S9538, S9542, S9559, S9560, S9562, S9590, T1001, T1002, T1003, T1004, T1021, T1022, T1028, T1030, T1031, T1502"
Home Hemodialysis - Oxford Clinical Policy
Effective Date: 05.01.2021 – This policy addresses home hemodialysis (HHD). Applicable Procedure Codes: 90963, 90964, 90965, 90966, 90967, 90968, 90969, 90970, 90989, 90993, 99512, S9335.
Home Traction Therapy - Oxford Clinical Policy
Effective Date: 07.01.2021 – This policy addresses home traction therapy. Applicable Procedure Codes: E0830, E0840, E0849, E0850, E0855, E0856, E0860, E0941.
Hysterectomy – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses hysterectomy. Applicable Procedure Codes: 58150, 58152, 58180, 58260, 58262, 58263, 58267, 58270, 58275, 58280, 58290, 58291, 58292, 58294, 58541, 58542, 58543, 58544, 58550, 58552, 58553, 58554, 58570, 58571, 58572, 58573.
Implantable Beta-Emitting Microspheres for Treatment of Malignant Tumors – Oxford Clinical Policy
Effective Date: 08.01.2022 – This policy addresses transarterial radioembolization (TARE) using yttrium-90 (90Y) microspheres for the treatment of malignant tumors. Applicable Procedure Codes: 37243, 79445, S2095.
Implanted Electrical Stimulator for Spinal Cord – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses implanted electrical spinal cord and dorsal root ganglion (DRG) stimulation. Applicable Procedure Codes: 63650, 63655, 63685, 63688, C1767, C1778, C1816, C1820, C1822, C1823, C1883, C1897, L8679, L8680, L8682, L8685, L8686, L8687, L8688, L8695.
Implanted Spinal Drug Delivery Systems – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses implanted spinal drug delivery systems for the treatment of cancer-related pain, severe spasticity, and chronic non-malignant pain. Applicable Procedure Codes: 62320, 62321, 62322, 62323, 62324, 62325, 62326, 62327, 62350, 62351, 62360, 62361, 62362.
In-Network Exceptions for Breast Reconstruction Surgery Following Mastectomy – Oxford Administrative Policy
Effective Date: 06.01.2021 – This policy addresses in-network exceptions for breast reconstruction surgery after mastectomy. Applicable Procedure Codes: 11920, 11921, 11922, 11970, 11971, 15271, 15272, 15777, 19316, 19325, 19330, 19340, 19350, 19355, 19357, 19361, 19364, 19367, 19368, 19369, 19380, 19396, 19499, 19318, L8600, S2066, S2067, S2068, S8950.
In-Office Laboratory Testing and Procedures List – Oxford Administrative Policy
Effective Date: 01.01.2022 – This policy addresses laboratory testing/procedures that Oxford Network physicians may provide in their offices, including specimen handling and venipuncture.
Infertility Diagnosis and Treatment – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses diagnostic and therapeutic procedures for infertility and cryopreservation.
"0568T, 0253U, 52402, 54500, 54505, 55300, 55530, 55535. 55550, 55870, 58140, 58145, 58146, 58321, 58322, 58323, 58340, 58345, 58350, 58545, 58546, 58555, 58559, 58660, 58662, 58670, 58672, 58673, 58740, 58752, 58760, 58770, 58800, 58805, 58920, 58970, 58974, 58976, 74440, 74740, 74742, 76830, 76831, 76856, 76857, 76870, 76872, 76948, 80415, 80426, 81224, 82397, 82670, 83001, 83002, 83498, 83520, 84144, 84146, 84402, 84403, 84443, 84830, 88182, 88248, 88261, 88262, 88263, 88273, 88280, 88283, 88285, 89250, 89251, 89253, 89254, 89255, 89257, 89258, 89259, 89260, 89261, 89264, 89268, 89272, 89280, 89281, 89290, 89291, 89300, 89310, 89320, 89321, 89322, 89325, 89329, 89330, 89331, 89335, 89337, 89342, 89343, 89344, 89346, 89352, 89353, 89354, 89356, 89398, J0725, J3355, S0122, S0126, S0128, S0132, S3655, S4011, S4013, S4014, S4015, S4016, S4017, S4018, S4020, S4021, S4022, S4023, S4025, S4026, S4027, S4028, S4030, S4031, S4035, S4037, S4040",
Inhaled Nitric Oxide Therapy – Oxford Clinical Policy
Effective Date: 03.01.2022 – This policy addresses the use of inhaled nitric oxide (iNO) for treating term or near-term infants with hypoxic respiratory failure or echocardiographic evidence of persistent pulmonary hypertension of the newborn (PPHN). Applicable Procedure Code: 94799.
Intensity-Modulated Radiation Therapy – Oxford Clinical Policy
Effective Date: 08.01.2022 – This policy addresses the use of intensity-modulated radiation therapy (IMRT). Applicable Procedure Codes: 77301, 77338, 77385, 77386, 77387, 77520, 77522, 77523, 77525, G6015, G6016, G6017.
Intraoperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC) - Oxford Clinical Policy
Effective Date: 11.01.2021 – This policy addresses intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC). Applicable Procedure Code: 96549.
Intrauterine Fetal Surgery - Oxford Clinical Policy
Effective Date: 11.01.2021 – This policy addresses intrauterine fetal surgery (IUFS) and fetoscopic endoluminal tracheal occlusion (FETO) . Applicable Procedure Codes: 59072, 59074, 59076, 59897, S2400, S2401, S2402, S2403, S2404, S2405, S2409, S2411.
Laser Interstitial Thermal Therapy – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses laser interstitial thermal therapy. Applicable Procedure Codes: 19499, 20999, 27599, 32999, 53899, 55899, 61736, 61737, 64999.
Light and Laser Therapy - Oxford Clinical Policy
Effective Date: 11.01.2021 – This policy addresses light and laser therapy, including light phototherapy, photodynamic therapy, intense pulsed light, pulsed dye laser, and laser hair removal. Applicable Procedure Codes: 17106, 17107, 17108, 17380.
Liposuction for Lipedema – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses liposuction for lipedema when used to treat functional impairment. Applicable Procedure Codes: 15877, 15878, 15879.
Lithotripsy for Salivary Stones - Oxford Clinical Policy
Effective Date: 11.01.2021 – This policy addresses extracorporeal shock wave lithotripsy (ESWL) and endoscopic intracorporeal laser lithotripsy for treating salivary stones. Applicable Procedure Code: 42699.
Lower Extremity Invasive Diagnostic and Endovascular Procedures – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses lower extremity vascular angiography and endovascular revascularization procedures. Applicable Procedure Codes: 37220, 37221, 37222, 37223, 37224, 37225, 37226, 37227, 37228, 37229, 37230, 37231, 37232, 37233, 37234, 37235, 75710, 75716.
Lyme Disease – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses the use of parenteral antibiotics for treating Lyme disease. Applicable Procedure Codes: J0456, J0558, J0561, J0696, J0698, J2510, J2540.
Macular Degeneration Treatment Procedures – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses implantable miniature telescope (IMT), conjunctival incision with posterior extrascleral placement of a pharmacologic agent, laser photocoagulation, and radiation therapy. Applicable Procedure Codes: 0308T, 67036, 67299, 92499.
Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) Scan – Site of Service – Oxford Clinical Policy
Effective Date: 04.01.2022 – This policy addresses advanced radiologic imaging procedures performed in a hospital outpatient department.
70336, 70450, 70460, 70470, 70480, 70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 70496, 70498, 70540, 70542, 70543, 70544, 70545, 70546, 70547, 70548, 70549, 70551, 70552, 70553, 70554, 70555, 71250, 71260, 71270, 71275, 71550, 71551, 71552, 71555, 72125, 72126, 72127, 72128, 72129, 72130, 72131, 72132, 72133, 72141, 72142, 72146, 72147, 72148, 72149, 72156, 72157, 72158, 72159, 71271, 72191, 72192, 72193, 72194, 72195, 72196, 72197, 72198, 73200, 73201, 73202, 73206, 73218, 73219, 73220, 73221, 73222, 73223, 73225, 73700, 73701, 73702, 73706, 73718, 73719, 73720, 73721, 73722, 73723, 73725, 74150, 74160, 74170, 74174, 74175, 74176, 74177, 74178, 74181, 74182, 74183, 74185, 74261, 74262, 74263, 74712, 74713, 75557, 75559, 75561, 75563, 75571, 75572, 75573, 75574, 75635, 76380, 76390, 76497, 76498, 77046, 77047, 77048, 77049, 77084, C8900, C8901, C8902, C8903, C8905, C8906, C8908, C8909, C8910, C8911, C8912, C8913, C8914, C8918, C8919, C8920, C8931, C8932, C8933, C8934, C8935, C8936, S8037, S8042
Manipulation Under Anesthesia – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses manipulation under anesthesia (MUA). Applicable Procedure Codes: 21073, 22505, 23700, 25259, 26340, 27198, 27275, 27570, 27860, D7830.
Manipulative Therapy - Oxford Clinical Policy
Effective Date: 07.01.2021 – This policy addresses manipulative therapy. Applicable Procedure Codes: 98925, 98926, 98927, 98928, 98929, 98940, 98941, 98942, 98943, S8990.
Manual Wheelchairs – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses manual wheelchairs.
"E1037, E1038, E1039, E1050, E1060, E1070, E1083, E1084, E1085, E1086, E1087, E1088, E1089, E1090, E1092, E1093, E1100, E1110, E1130, E1140, E1150, E1160, E1161, E1170, E1171, E1172, E1180, E1190, E1195, E1200, E1220, E1221, E1222, E1223, E1224, E1229, E1231, E1232, E1233, E1234, E1235, E1236, E1237, E1238, E1240, E1250, E1260, E1270, E1280, E1285, E1290, E1295, K0001, K0002, K0003, K0004, K0005, K0006, K0007, K0008, K0009"
Mechanical Stretching Devices – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses the use of low-load prolonged-duration stretch devices, static progressive (SP) stretch splint devices, and patient actuated serial stretch (PASS) devices. Applicable Procedure Codes: E1399, E1800, E1801, E1802, E1805, E1806, E1810, E1811, E1812, E1815, E1816, E1818, E1825, E1830, E1831, E1840, E1841.
Member Administrative Grievance & Appeal (Non UM) Process & Timeframes – Oxford Administrative Policy
Effective Date: 12.01.2021 – This policy addresses the process and timeframes of an administrative grievance/appeal.
Meniscus Implant and Allograft - Oxford Clinical Policy
Effective Date: 09.01.2021 – This policy addresses meniscus allograft transplantation with human cadaver tissue and collagen meniscus implants. Applicable Procedure Codes: 29868, G0428.
Minimally Invasive Procedures for Gastroesophageal Reflux Disease (GERD) and Achalasia – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses minimally invasive endoscopic procedures and devices for treating gastroesophageal reflux disease (GERD) and the Per Oral Endoscopic Myotomy (POEM) procedure for achalasia or diffuse esophageal spasm. Applicable Procedure Codes: 43210, 43257, 43284, 43289, 43497, 43499, 43999.
Molecular Oncology Testing for Cancer Diagnosis, Prognosis, and Treatment Decisions – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses molecular oncology testing for cancer indications, including breast cancer, thyroid cancer, hematological cancer, and lung cancer.
Motorized Spinal Traction - Oxford Clinical Policy
Effective Date: 07.01.2021 – This policy addresses motorized spinal traction devices. Applicable Procedure Code: S9090.
Negative Pressure Wound Therapy – Oxford Clinical Policy
Effective Date: 05.01.2022 – This policy addresses negative pressure wound therapy. Applicable Procedure Codes: 97605, 97606, 97607, 97608, A6550, A9272, E2402.
Nerve Graft to Restore Erectile Function During Radical Prostatectomy - Oxford Clinical Policy
Effective Date: 12.01.2021 – This policy addresses autologous (sural) and allogenic nerve grafts to restore erectile function during or after radical prostatectomy . Applicable Procedure Codes: 55899, 64999.
Neurophysiologic Testing and Monitoring - Oxford Clinical Policy
Effective Date: 12.01.2021 – This policy addresses nerve conduction studies and other neurophysiological testing.
0106T, 0107T, 0108T, 0109T, 0110T, 0464T, 0533T, 0534T, 0535T, 0536T, 95860, 95861, 95863, 95864, 95865, 95866, 95867, 95868, 95869, 95870, 95872, 95873, 95874, 95885, 95886, 95887, 95905, 95907, 95908, 95909, 95910, 95911, 95912, 95913, 95937, 95999, 96002, 96003, 96004, A9279, A9280, G0255, S3900
Neuropsychological Testing Under the Medical Benefit - Oxford Clinical Policy
Effective Date: 09.01.2021 – This policy addresses neuropsychological testing and computerized cognitive testing under the medical benefit. Applicable Procedure Codes: 96116, 96121, 96132, 96133, 96136, 96137, 96138, 96139, 96146.
Newborns – Oxford Administrative Policy
Effective Date: 04.01.2022 – This policy addresses enrollment and coverage of newborns.
Observation Services – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses observation services in a hospital setting.
Obstetrical Ultrasonography – Oxford Clinical Policy
Effective Date: 11.01.2021 – This policy addresses obstetrical ultrasounds. Applicable Procedure Codes: 76801, 76802, 76805, 76810, 76811, 76812, 76813, 76814, 76815, 76816, 76817, 76818, 76819, 76820, 76821, 76825, 76826, 76827, 76828.
Obstructive and Central Sleep Apnea Treatment – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses nonsurgical and surgical treatment of obstructive sleep apnea (OSA). Applicable Procedure Codes: 0424T, 0425T, 0426T, 0427T, 0428T, 0429T, 0430T, 0431T, 0432T, 0433T, 0434T, 0435T, 0436T, 21142, 21199, 21206, 21685, 41512, 41530, 41599, 42145, 42299, 64553, 64568, 64569, 64570, 64582, 64583, 64584, E0485, E0486, E1399, K1001, K1027, K1028, K1029, L8679, L8680, L8686, S2080, S2900.
Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses occipital neuralgia and headache treatments, including occipital nerve blocks and occipital nerve ablation. Applicable Procedure Codes: 63185, 63190, 64405, 64553, 64555, 64568, 64570, 64575, 64590, 64633, 64634, 64722, 64744, 64771, 64999, K1023, L8679, L8680, L8685.
Office Based Procedures – Site of Service – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses certain elective procedures that are typically performed in an office setting but may be performed in an ambulatory surgical center in certain circumstances. Applicable Procedure Codes: 11402, 11403, 11404, 11406, 11420, 11421, 11422, 11423, 11424, 11426, 11442, 19000, 20552, 20553, 27096, 31579, 57460, 62270, 62321, 64479, 64490, 64493, 64633, 64635.
Omnibus Codes – Oxford Clinical Policy
Effective Date: 04.01.2022 – This policy addresses multiple services/procedures.
"0042T, 0061U, 0100T, 0163U, 0174T, 0175T, 0207T, 0208T, 0209T, 0210T, 0211T, 0212T, 0247U, 0266T, 0267T, 0268T, 0269T, 0270T, 0271T, 0272T, 0273T, 0330T, 0331T, 0332T, 0335T, 0338T, 0339T, 0351T, 0352T, 0353T, 0354T, 0358T, 0394T, 0395T, 0397T, 0398T, 0408T, 0409T, 0410T, 0411T, 0412T, 0413T, 0414T, 0415T, 0416T, 0417T, 0418T, 0440T, 0441T, 0442T, 0444T, 0445T, 0469T, 0472T, 0473T, 0479T, 0480T, 0485T, 0486T, 0487T, 0491T, 0492T, 0493T, 0506T, 0507T, 0508T, 0509T, 0510T, 0511T, 0515T, 0516T, 0517T, 0518T, 0519T, 0520T, 0521T, 0522T, 0525T, 0526T, 0527T, 0528T, 0529T, 0530T, 0531T, 0532T, 0547T, 0559T, 0560T, 0561T, 0562T, 0563T, 0567T, 0581T, 0582T, 0583T, 0584T, 0585T, 0586T, 0596T, 0597T, 0598T, 0599T, 0631T, 0640T, 0641T, 0642T, 0647T, 0651T, 0658T, 0664T, 0665T, 0666T, 0667T, 0668T, 0669T, 0670T, 0672T, 0692T, 0693T, 0694T, 19105, 19294, 27299, 27599, 29799, 30117, 30468, 30999, 31634, 33267, 33268, 33269, 33274, 33275, 33340, 33999, 37799, 43206, 43252, 48160, 48999, 53451, 53452, 53453, 53454, 53860, 53899, 58999, 60659, 63268, 64624, 64454, 69705, 69706, 69799, 76120, 76125, 77424, 77425, 77469, 80145, 80230, 80280, 80299, 81490, 81599, 84999, 86849, 88375, 90999, 91113, 92274, 93702, 94011, 94012, 94013, 96999, 97139, 97799, 99174, 99177, A9999, B4105, E1399, G0341, G0342, G0343, G0429, K1006, K1007, K1018, K1019, K1030, L2999, L5781, L5782, L8607, L8608, L8699, L8701, L8702, P2031, Q2026, Q2028, S2102, S2117"
Orthognathic (Jaw) Surgery – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses orthognathic (jaw) surgery.
"21076, 21079, 21080, 21081, 21082, 21083, 21120, 21121, 21122, 21123, 21125, 21127, 21141, 21142, 21143, 21145, 21146, 21147, 21150, 21151, 21154, 21155, 21159, 21160, 21188, 21193, 21194, 21195, 21196, 21198, 21199, 21206, 21210, 21215, 21244, 21245, 21246, 21247, D5934, D5935, D5982, D5988, D7471, D7472, D7473, D7490, D7610, D7630, D7650, D7671, D7680, D7710, D7730, D7750, D7770, D7780, D7940, D7941, D7943, D7944, D7945, D7946, D7947, D7948, D7949, D7950, D7953, D7955, D7995, D7996, D7997"
Orthopedic Services – Oxford Administrative Policy
Effective Date: 09.01.2022 – This policy addresses services subject to utilization review with OrthoNet's orthopedic division.
"0095T 0098T 0164T 0309T 20930 20931 22100 22101 22102 22110 22112 22114 22206 22207 22210 22212 22214 22220 22224 22510 22511 22512 22513 22514 22515 22532 22533 22534 22548 22551 22552 22554 22556 22558 22585 22586 22590 22595 22600 22610 22612 22614 22630 22632 22633 22634 22800 22802 22804 22808 22810 22812 22818 22819 22830 22840 22841 22842 22843 22844 22845 22846 22847 22848 22849 22850 22852 22853 22854 22855 22856 22857 22858 22859 22861 22862 22864 22865 22899 23470 23472 23473 23474 24360 24361 24362 24363 24370 24371 27120 27125 27130 27132 27134 27137 27138 27279 27280 27412 27437 27438 27440 27441 27442 27443 27445 27446 27447 27486 27487 28285 28289 28291 28292 28296 28297 28298 28299 29805 29806 29807 29819 29820 29821 29822 29823 29824 29825 29826 29827 29828 29830 29834 29835 29836 29837 29838 29840 29843 29844 29845 29846 29847 29848 29860 29861 29862 29863 29866 29867 29868 29870 29871 29873 29874 29875 29876 29877 29879 29880 29881 29882 29883 29884 29885 29886 29887 29888 29889 29891 29892 29893 29894 29895 29897 29898 29899 29914 29915 29916 63001 63003 63005 63011 63012 63015 63016 63017 63020 63030 63035 63040 63042 63043 63044 63045 63046 63047 63048 63050 63051 63055 63056 63057 63064 63066 63075 63076 63077 63078 63081 63082 63085 63086 63087 63088 63090 63091 63101 63102 63103 63170 63172 63173 63185 63190 63191 63197 63200 63250 63251 63252 63265 63266 63267 63268 63270 63271 63272 63273 63275 63276 63277 63278 63280 63281 63282 63283 63285 63286 63287 63290 63295 63300 63301 63302 63303 63304 63305 63306 63307 63308 63650 63655 63661 63662 63663 63664 63685 63688 64553 64570 J7330 L8680 L8682 L8685 L8686 L8687 L8688 S2112",
Otoacoustic Emissions Testing – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses neonatal hearing screening, auditory screening, and diagnostic testing using otoacoustic emissions (OAEs). Applicable Procedure Codes: 92558, 92587, 92588.
Outpatient Physical and Occupational Therapy – Oxford Clinical Policy
Effective Date: 10.01.2021 – This policy addresses outpatient physical and occupational therapy services managed by OptumHealth Care Solutions.
Outpatient Surgical Procedures – Site of Service – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses the medical necessity of certain planned surgical procedures when performed in a hospital outpatient department.
Oxford's Outpatient Imaging Self-Referral – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses self-referral for outpatient imaging services.
Panniculectomy and Body Contouring Procedures - Oxford Clinical Policy
Effective Date: 10.01.2021 – This policy addresses panniculectomy, abdominoplasty, lipectomy, repair of diastasis recti, and suction-assisted lipectomy. Applicable Procedure Codes: 15830, 15832, 15833, 15834, 15835, 15836, 15837, 15838, 15839, 15847, 15876, 15877, 15878, 15879.
Participating Gastroenterologists Using Non-Participating Anesthesiologists: In-Office and Ambulatory – Oxford Administrative Policy
Effective Date: 05.01.2020 – This policy addresses participating gastroenterologists located in New York performing non-emergent procedures using nonparticipating anesthesiologists in office (IO) or in an ambulatory surgery center (ASC).
Participating Providers Using Non-Participating Laboratory and Pathology Providers Protocol – Oxford Administrative Policy
Effective Date: 05.01.2020 – This policy addresses participating providers treating a member on a Connecticut (CT) or New York (NY) product and wants to use a non-participating laboratory/pathologist or wants to provide the member with a form to obtain laboratory/pathology services outside the physician office.
Participating Providers Using Non-Participating Providers Protocol – Oxford Administrative Policy
Effective Date: 07.01.2022 – This policy addresses a participating provider's use of a non-participating provider physician, facility, or other healthcare provider in a member's care, and the Member Advanced Notice Form.
Participating Surgeons Using Non-Participating Assistant Surgeons and Co-Surgeons Protocol – Oxford Administrative Policy
Effective Date: 05.01.2020 – This policy addresses participating surgeons located in New York using non-participating assistant surgeons and co-surgeons for non-emergent procedures.
Participating Surgeons Using Non-Participating Providers for Intraoperative Neuro-Monitoring (IONM) Protocol – Oxford Administrative Policy
Effective Date: 07.01.2022 – This policy addresses participating providers in New York and Connecticut using non-participating providers for intraoperative neuro-monitoring (IONM).
Patient Lifts – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses patient lifts. Applicable Procedure Codes: E0621, E0625, E0630, E0635, E0636, E0639, E0640, E1035, E1036.
Pectus Deformity Repair - Oxford Clinical Policy
Effective Date: 07.01.2021 – This policy addresses surgical repair of pectus excavatum and pectus carinatum. Applicable Procedure Codes: 21740, 21742, 21743.
Pediatric Gait Trainers, Standing Systems, and Walkers – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses pediatric gait trainers, standing systems, and walkers. Applicable Procedure Codes: A4636, A4637, E0130, E0135, E0140, E0141, E0143, E0144, E0147, E0148, E0149, E0154, E0155, E0156, E0157, E0158, E0159, E0637, E0638, E0641, E0642, E8000, E8001, E8002.
Pediatric Outpatient Intensive Feeding Programs – Oxford Clinical Policy
Effective Date: 05.01.2022 – This policy addresses pediatric outpatient intensive feeding programs. Applicable Procedure Code: 92526.
Percutaneous Neuroablation for Severe Cancer Pain and Trigeminal Neuralgia – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses percutaneous neuroablation for the treatment of severe cancer pain and trigeminal neuralgia. Applicable Procedure Codes: 64605, 64610, 64620, 64640.
Percutaneous Patent Foramen Ovale (PFO) Closure – Oxford Clinical Policy
Effective Date: 04.01.2022 – This policy addresses percutaneous patent foramen ovale closure for the prevention of recurrent ischemic stroke. Applicable Procedure Code: 93580.
Percutaneous Vertebroplasty and Kyphoplasty - Oxford Clinical Policy
Effective Date: 12.01.2021 – This policy addresses percutaneous vertebroplasty and kyphoplasty for treating spinal pain. Applicable Procedure Codes: 22510, 22511, 22512, 22513, 22514, 22515.
Pharmacogenetic Testing – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses the use of pharmacogenetic multi-gene panel testing for genetic polymorphisms. Applicable Procedure Codes: 0029U, 0078U, 0173U, 0175U, 0286U, 0290U, 0291U, 0292U, 0293U, 81479.
Physical, Occupational, and Speech Therapy including Cognitive/Neuropsychological Rehabilitation for New Jersey Small Group Members – Oxford Clinical Policy
Effective Date: 10.01.2021 – This policy addresses physical, occupational, speech, and cognitive therapy, and therapeutic manipulation for New Jersey Small Group members.
Plagiocephaly and Craniosynostosis Treatment – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses the use of cranial orthotic devices for treating infants following craniosynostosis surgery or for nonsynostotic (nonfusion) deformational or positional plagiocephaly. Applicable Procedure Codes: 21175, D5924, L0112, L0113, S1040.
Pneumatic Compression Devices – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses pneumatic and intermittent limb compression devices. Applicable Procedure Codes: A4600, E0650, E0651, E0652, E0655, E0660, E0665, E0666, E0667, E0668, E0669, E0670, E0671, E0672, E0673, E0675, E0676.
Power Mobility Devices – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses power mobility devices.
"E0983, E0984, E0986, K0013, K0800, K0801, K0802, K0806, K0807, K0808, K0812, K0813, K0814, K0815, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0828, K0829, K0830, K0831, K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843, K0848, K0849, K0850, K0851, K0852, K0853, K0854, K0855, K0856, K0857, K0858, K0859, K0860, K0861, K0862, K0863, K0864, K0868, K0869, K0870, K0871, K0877, K0878, K0879, K0880, K0884, K0885, K0886, K0890, K0891, K0898, K0899"
Preimplantation Genetic Testing (PGT) and Related Services – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses preimplantation genetic testing (PGT) and related services. Applicable Procedure Codes: 58970, 58974, 76948, 81228, 81229, 81349, 81479, 89250, 89251, 89253, 89254, 89255, 89258, 89260, 89261, 89264, 89268, 89272, 89280, 89281, 89290, 89291, 89342, 89257, 89352, S4011, S4015, S4016, S4022, S4037.
PGT-M, PGT-SR,
Preimplantation Genetic Testing – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses preimplantation genetic testing (PGT). Applicable Procedure Codes: 0254U, 81228, 81229, 81479.
Preventive Care Services – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses preventive care services.
Prior Authorization Exemptions for Outpatient Services – Oxford Administrative Policy
Effective Date: 07.01.2022 – This policy addresses services which are exempt from the standard outpatient prior authorization requirement.
Private Duty Nursing Services – Oxford Clinical Policy
Effective Date: 08.01.2022 – This policy addresses private duty nursing (PDN) services. Applicable Procedure Code: T1000.
Prolotherapy and Platelet Rich Plasma Therapies – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses prolotherapy and platelet rich plasma. Applicable Procedure Codes: 0232T, G0460, G0465, M0076, P9020.
Prostate Surgeries and Interventions – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses prostrate surgeries and interventions, including transurethral ablation, cryoablation, surgical prostatectomy, prostatic urethral lift (PUL), high-energy water vapor thermotherapy, and transperineal placement of biodegradable material. Applicable Procedure Codes: 0421T, 0582T, 0655T, 37243, 52441, 52442, 53850, 53852, 53854, 53855, 55866, 55873, 55874.
Prosthetic Devices, Wigs, Specialized, Microprocessor or Myoelectric Limbs – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses prosthetic devices, specialized/computerized/myoelectric limbs, and wigs, and includes applicable procedure codes for breast prosthesis, ear/eye/nose/facial prosthesis, lower and upper limb prosthetics, additions to upper extremity, prosthetic socks, repairs and replacements, and wigs.
Proton Beam Radiation Therapy – Oxford Clinical Policy
Effective Date: 05.01.2022 – This policy addresses proton beam radiation therapy. Applicable Procedure Codes: 77301, 77338, 77385, 77386, 77387, 77520, 77522, 77523, 77525, G6015, G6016, G6017.
Radiation Therapy: Fractionation, Image Guidance, and Special Services - Oxford Clinical Policy
Effective Date: 11.01.2021 – This policy addresses radiation therapy fractionation, image-guided radiation therapy (IGRT), and special radiation therapy services. Applicable Procedure Codes: 77014, 77331, 77370, 77385, 77386, 77387, 77399, 77401, 77402, 77407, 77412, 77470, 77520, 77522, 77523, 77525, G6001, G6002, G6003, G6004, G6005, G6006, G6007, G6008, G6009, G6010, G6011, G6012, G6013, G6014, G6015, G6016, G6017.
Radiology Procedures Requiring Prior Authorization for eviCore healthcare Arrangement – Oxford Clinical Policy
Effective Date: 04.01.2022 – This policy addresses radiology procedures which require precertification by eviCore healthcare, including computerized axial tomography (CAT) scan, CT colonography/virtual colonoscopy (for diagnostic purposes), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), nuclear medicine imaging, positron emission tomography (PET) scans, and obstetrical ultrasound.
"0174T, 0175T, 0609T, 0610T, 0611T, 0612T, 0623T, 0624T, 0625T, 0626T, 0633T, 0634T, 0635T, 0636T, 0637T, 0638T, 0648T, 0649T, 70336, 70450, 70460, 70470, 70480, 70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 70496, 70498, 70540, 70542, 70543, 70544, 70545, 70546, 70547, 70548, 70549, 70551, 70552, 70553, 70554, 70555, 71250, 71260, 71270, 71271, 71275, 71550, 71551, 71552, 71555, 72125, 72126, 72127, 72128, 72129, 72130, 72131, 72132, 72133, 72141, 72142, 72146, 72147, 72148, 72149, 72156, 72157, 72158, 72159, 72191, 72192, 72193, 72194, 72195, 72196, 72197, 72198, 73200, 73201, 73202, 73206, 73218, 73219, 73220, 73221, 73222, 73223, 73225, 73700, 73701, 73702, 73706, 73718, 73719, 73720, 73721, 73722, 73723, 73725, 74150, 74160, 74170, 74174, 74175, 74176, 74177, 74178, 74181, 74182, 74183, 74185, 74261, 74262, 74263, 74712, 74713, 75635, 76376, 76377, 76380, 76390, 76391, 76497, 76498, 76499, 76801, 76802, 76805, 76810, 76811, 76812, 76813, 76814, 76815, 76816, 76817, 76818, 76819, 76820, 76821, 76825, 76826, 76827, 76828, 76975, 77021, 77022, 77046, 77047, 77048, 77049, 77084, 78012, 78013, 78014, 78015, 78016, 78018, 78020, 78070, 78071, 78072, 78075, 78099, 78102, 78103, 78104, 78185, 78195, 78199, 78201, 78202, 78215, 78216, 78226, 78227, 78230, 78231, 78232, 78258, 78261, 78262, 78264, 78265, 78266, 78278, 78282, 78290, 78291, 78299, 78300, 78305, 78306, 78315, 78399, 78414, 78428, 78429, 78430, 78431, 78432, 78433, 78445, 78456, 78457, 78458, 78459, 78466, 78468, 78469, 78472, 78473, 78481, 78483, 78491, 78492, 78494, 78496, 78499, 78579, 78580, 78582, 78597, 78598, 78599, 78600, 78601, 78605, 78606, 78608, 78609, 78610, 78630, 78635, 78645, 78650, 78660, 78699, 78700, 78701, 78707, 78708, 78709, 78725, 78730, 78740, 78761, 78799, 78800, 78801, 78802, 78803, 78804, 78811, 78812, 78813, 78814, 78815, 78816, 78830, 78831, 78832, 78999, C8900, C8901, C8902, C8903, C8905, C8906, C8908, C8909, C8910, C8911, C8912, C8913, C8914, C8918, C8919, C8920, C8931, C8932, C8933, C8934, C8935, C8936, C8937, G0235, G0252, S8037, S8042, S8080, 78205, 78320, 78607, 78647, 78710, 78805, 78806, 78807, 78831, 78832"
Radiopharmaceuticals and Contrast Media – Oxford Clinical Policy
Effective Date: 11.01.2021 – This policy addresses radiopharmaceuticals and contrast media administered by eviCore healthcare.
Requests for In-Network Exceptions – Oxford Administrative Policy
Effective Date: 09.01.2020 – This policy addresses the review of in-network exception requests for members residing within Oxford's service area.
Rhinoplasty and Other Nasal Surgeries – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses lysis intranasal synechia, repair of nasal vestibular stenosis or alar collapse, rhinoplasty, rhinophyma, septal dermatoplasty, and nasal polypectomy. Applicable Procedure Codes: 30120, 30400, 30410, 30420, 30430, 30435, 30450, 30460, 30462, 30465, 30560, 30620, 31237.
Routine Foot Care – Oxford Clinical Policy
Effective Date: 05.01.2022 – This policy addresses routine foot care for members with diabetes or who are at risk for neurological or vascular disease arising from diseases such as diabetes.
"11055, 11056, 11057, 11719, 11720, 11721, 28735, A5500, A5501, A5503, A5504, A5505, A5506, A5507, A5508, A5510, A5512, A5513, A5514, A9285, G0127, L3000, L3001, L3002, L3003, L3010, L3020, L3030, L3031, L3040, L3050, L3060, L3070, L3080, L3090, L3140, L3150, L3160, L3170, L3201, L3202, L3203, L3204, L3206, L3207, L3215, L3216, L3217, L3219, L3221, L3222, L3230, L3250, L3251, L3252, L3253, L3254, L3255, L3257, L3265, L3300, L3310, L3320, L3330, L3332, L3334, L3340, L3350, L3360, L3370, L3380, L3390, L3400, L3410, L3420, L3430, L3440, L3450, L3455, L3460, L3465, L3470, L3480, L3485, L3500, L3510, L3520, L3530, L3540, L3550, L3560, L3570, L3580, L3590, L3595, L3600, L3610, L3620, L3630, L3640, L3649, S0390, S0395"
Sacroiliac Joint Injections – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses sacroiliac joint interventions, including sacroiliac joint injections and sacroiliac joint fusion. Applicable Procedure Codes: 27096, 27279, 27280, 64451, G0260.
Screening Colonoscopy Procedures – Site of Service – Oxford Clinical Policy
Effective Date: 10.01.2021 – This policy addresses planned preventive screening colonoscopies performed in a hospital outpatient department. Applicable Procedures Codes: 45378, 45380, 45381, 45384, 45385, G0105, G0121.
Sensory Integration Therapy and Auditory Integration Training – Oxford Clinical Policy
Effective Date: 12.01.2021 – This policy addresses sensory integration therapy and auditory integration training. Applicable Procedure Code: 97533.
Services Requiring Prior Authorization – Oxford Administrative Policy
Effective Date: 09.01.2022 – This policy addresses services requiring prior authorization and their related policies.
Site of Service Differential – Oxford Administrative Policy
Effective Date: 01.01.2022 – This policy addresses a site of service differential that reduces practice expense payments for services provided in facility or ambulance settings.
Skilled Care and Custodial Care Services – Oxford Administrative Policy
Effective Date: 07.01.2021 – This policy addresses skilled care and custodial care services. Applicable Procedure Codes: 99509, S5100, S5101, S5102, S5105, S5120, S5121, S5125, S5126, S5130, S5131, S5135, S5136, S5140, S5141, S5150, S5151, S5170, S5175, S9125, T1005, T1019, T1020.
Skin and Soft Tissue Substitutes – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses skin and soft tissue substitutes.
Speech Generating Devices – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses speech generating devices. Applicable Procedure Codes: E2500, E2502, E2504, E2506, E2508, E2510, E2511, E2512, E2599.
Speech Therapy and Early Intervention - Oxford Clinical Policy
Effective Date: 05.01.2020 – This policy addresses speech therapy and early intervention/birth to three programs. Applicable Procedure Codes: 92507, 92508, 92521, 92522, 92523, 92524, 92526, 92610, 92626, 92627, 92700, G0153, H2014, H2015, H2019, S9128, S9152, T1015, T1023, T1024, T1025, T1026, T1027, T1028, T2024.
Spinal Fusion Enhancement Products – Oxford Clinical Policy
Effective Date: 05.01.2022 – This policy addresses spinal fusion enhancement products. Applicable Procedure Codes: 20930, 20931, 20939, 22899.
Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery - Oxford Clinical Policy
Effective Date: 11.01.2021 – This policy addresses stereotactic radiation therapy, including stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT). Applicable Procedures Codes: 32701, 61796, 61797, 61798, 61799, 61800, 63620, 63621, 77301, 77371, 77372, 77373, 77432, 77435, G0339, G0340.
Surgery of the Ankle – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses surgery of the ankle. Applicable Procedure Codes: 27685, 27700, 27702, 27703, 27704, 29891, 29892, 29894, 29895, 29897, 29898, 29899.
Surgery of the Elbow – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses surgery of the elbow. Applicable Procedure Codes: 24360, 24361, 24362, 24363, 24366, 24370, 24371, 29830, 29834, 29837, 29838.
Surgery of the Foot – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses surgery of the foot. Applicable Procedure Codes: 28285, 28289, 28291, 28292, 28295, 28297, 28298, 28299, 28296, 28299, 29893.
Surgery of the Hand or Wrist – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses surgery of the hand or wrist. Applicable Procedure Codes: 25280, 25332, 25441, 25442, 25443, 25444, 25445, 25446, 25447, 25449, 26530, 26531, 26535, 26536, 29840, 29843, 29844, 29845, 29846, 29847.
Surgery of the Hip – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses surgery of the hip and femoroacetabular impingement (FAI) syndrome. Applicable Procedure Codes: 27120, 27125, 27130, 27132, 27134, 27137, 27138, 27299, 29860, 29861, 29862, 29863, 29914, 29915, 29916, 29999, S2118.
Surgery of the Knee – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses surgery of the knee. Applicable Procedure Codes: 27437, 27438, 27440, 27441, 27442, 27443, 27445, 27446, 27447, 27486, 27487, 29870, 29871, 29873, 29874, 29875, 29876, 29877, 29880, 29881, 29882, 29883, 29884, 29885, 29886, 29887, 29888, 29889.
Surgery of the Shoulder – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses surgery of the shoulder. Applicable Procedure Codes: 23470, 23472, 23473, 23474, 29805, 29806, 29807, 29819, 29820, 29821, 29822, 29823, 29824, 29825, 29826, 29827, 29828.
Surgical and Ablative Procedures for Venous Insufficiency and Varicose Veins – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses varicose vein ablative and stripping procedures and ligation procedures. Applicable Procedure Codes: 36465, 36466, 36473, 36474, 36475, 36476, 36478, 36479, 36482, 36483, 37500, 37700, 37718, 37722, 37735, 37760, 37761, 37765, 37766, 37780, 37785, 37799.
Surgical Treatment for Spine Pain – Oxford Clinical Policy
Effective Date: 07.01.2022 – This policy addresses surgical treatment for spine pain.
"0200T, 0201T, 0202T, 0219T, 0220T, 0221T, 0222T, 0274T, 0275T, 0719T, 20930, 20931, 20939, 22100, 22101, 22102, 22103, 22110, 22112, 22114, 22116, 22206, 22207, 22208, 22210, 22212, 22214, 22216, 22220, 22222, 22224, 22226, 22532, 22533, 22534, 22548, 22551, 22552, 22554. 22556, 22558, 22585, 22586, 22590, 22595, 22600, 22610, 22612, 22614, 22630, 22632, 22633, 22634, 22800, 22802, 22804, 22808, 22810, 22812, 22818, 22819, 22830, 22840, 22841, 22842, 22843, 22844, 22845, 22846, 22847, 22848, 22849, 22850, 22852, 22853, 22854, 22855, 22859, 22867, 22868, 22869, 22870, 22899, 62380, 63001, 63003, 63005, 63011, 63012, 63015, 63016, 63017, 63020, 63030, 63035, 63040, 63042, 63043, 63044, 63045, 63046, 63047, 63048, 63050, 63051, 63055, 63056, 63057, 63064, 63066, 63075, 63076, 63077, 63078, 63081, 63082, 63085, 63086, 63087, 63088, 63090, 63091, 63101, 63102, 63103, 63170, 63172, 63173, 63185, 63190, 63191, 63194, 63195, 63196, 63197, 63198, 63199, 63200, 63250, 63251, 63252, 63265, 63266, 63267, 63268, 63270, 63271, 63272, 63275, 63277, 63280, 63282, 63285, 63286, 63287, 63290, 63300, 63301, 63302, 63303, 63304, 63305, 63306, 63307, 63308"
Sympathetic Blockade – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses the use of a sympathetic blockade using a local anesthetic. Applicable Procedure Codes: 64510, 64517, 64520, 64530.
Temporomandibular Joint Disorders – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses treatment of temporomandibular joint (TMJ) disorders. Applicable Procedure Codes: 20552, 20553, 20605, 20606, 21010, 21050, 21060, 21070, 21085, 21089, 21110, 21198, 21209, 21240, 21242, 21243, 21247, 21299, 21499, 29800, 29804, 90901, 97039, 97139, E0746, E1399, E1700, E1701, E1702.
Thermography - Oxford Clinical Policy
Effective Date: 05.01.2021 – This policy addresses thermography, including digital infrared thermal imaging, temperature gradient studies, and magnetic resonance (MR) thermography. Applicable Procedure Codes: 76498, 93740.
Timeframe Standards for Benefit Administrative Initial Decisions - Oxford Administrative Policy
Effective Date: 10.01.2021 – This policy addresses initial benefit administrative decision and notification timeframes.
Timeframe Standards for Utilization Management (UM) Initial Decisions - Oxford Administrative Policy
Effective Date: 05.01.2020 – This policy addresses initial utilization management decision and notification timeframes.
Total Artificial Disc Replacement for the Spine – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses cervical and lumbar artificial total disc replacement. Applicable Procedure Codes: 0095T, 0098T, 0163T, 0164T, 0165T, 22856, 22857, 22858, 22861, 22862, 22864, 22865, 22899.
Total Artificial Heart and Ventricular Assist Devices - Oxford Clinical Policy
Effective Date: 11.01.2021 – This policy addresses the SynCardia™ temporary Total Artificial Heart. Applicable Procedure Codes: 33927, 33928, 33975, 33976, 33979, 33981, 33982, 33983, 33995, 33997.
Transcatheter Heart Valve Procedures – Oxford Clinical Policy
Effective Date: 03.01.2022 – This policy addresses transcatheter heart valve (aortic, pulmonary, mitral) procedures. Applicable Procedure Codes: 0345T, 0483T, 0484T, 0543T, 0544T, 0545T, 0569T, 0570T, 0646T, 33361, 33362, 33363, 33364, 33365, 33366, 33367, 33368, 33369, 33370, 33418, 33419, 33477, 33999, 93799.
Transcranial Magnetic Stimulation – Oxford Clinical Policy
Effective Date: 04.01.2022 – This policy addresses transcranial magnetic stimulation and navigated transcranial magnetic stimulation (nTMS). Applicable Procedure Codes: 64999, 90867, 90868, 90869.
Transcutaneous Electrical Nerve/Joint Stimulators – Oxford Clinical Policy
Effective Date: 10.01.2021 – This policy addresses transcutaneous electrical nerve stimulator (TENS), including supplies and conductive garments. Applicable Procedure Codes: A4556, A4557, A4558, A4595, A4630, E0720, E0730, E0731, E0762, K1023.
Transpupillary Thermotherapy - Oxford Clinical Policy
Effective Date: 06.01.2021 – This policy addresses transpupillary thermotherapy. Applicable Procedure Codes: 67299, 92499.
Umbilical Cord Blood Harvesting and Storage for Future Use - Oxford Clinical Policy
Effective Date: 07.01.2021 – This policy addresses collection and storage of umbilical cord blood. Applicable Procedure Codes: 38205, 38206, 38207, 88240, S2140.
Unicondylar Spacer Devices for Treatment of Pain or Disability – Oxford Clinical Policy
Effective Date: 10.01.2021 – This policy addresses unicondylar spacer devices for treating knee joint pain or disability from any cause. Applicable Procedure Code: 27599.
Vagus and External Trigeminal Nerve Stimulation – Oxford Clinical Policy
Effective Date: 03.01.2022 – This policy addresses implantable vagus nerve stimulators and transcutaneous (non-implantable) vagus and trigeminal nerve stimulators. Applicable Procedure Codes: 61885, 61886, 64553, 64568, 64570, E0770, E1399, K1016, K1017, K1020, L8679, L8680, L8682, L8683, L8685, L8686, L8687, L8688.
Vertebral Body Tethering for Scoliosis – Oxford Clinical Policy
Effective Date: 02.01.2022 – This policy addresses vertebral body tethering for the treatment of scoliosis. Applicable Procedure Code: 0656T, 0657T, 22899.
Video Electroencephalographic (vEEG) Monitoring and Recording – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses video electroencephalographic (EEG) monitoring and recording. Applicable Procedure Codes: 95700, 95711, 95712, 95713, 95714, 95715, 95716, 95718, 95720, 95722, 95724, 95726.
Virtual Upper Gastrointestinal Endoscopy – Oxford Clinical Policy
Effective Date: 12.01.2021 – This policy addresses virtual upper gastrointestinal endoscopy. Applicable Procedure Codes: 76497, 76498.
Visual Information Processing Evaluation and Orthoptic and Vision Therapy – Oxford Clinical Policy
Effective Date: 05.01.2022 – This policy addresses occlusion therapy, pharmacologic penalization therapy, orthoptic or vision therapy, prism adaptation therapy, visual perception therapy, vision restoration therapy, and the use of visual information processing evaluations to diagnose reading or learning disabilities. Applicable Procedure Codes: 0687T, 0688T, 0704T, 0705T, 0706T, 92065, 92499.
Vitamin D Testing – Oxford Clinical Policy
Effective Date: 03.01.2022 – This policy addresses vitamin D testing. Applicable Procedure Codes: 0038U, 82306, 82652.
Warming Therapy and Ultrasound Therapy for Wounds – Oxford Clinical Policy
Effective Date: 01.01.2022 – This policy addresses warming therapy, noncontact normothermic wound therapy, and low frequency ultrasound for treating wounds. Applicable Procedure Codes: 97610, A6000, E0231, E0232.
Wheelchair Options and Accessories – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses wheelchair options and accessories.
"A9270, E0950, E0954, E0958, E0967, E0971, E0973, E0974, E0978, E0981, E0982, E0988, E0990, E0995, E1002, E1003, E1004, E1005, E1006, E1007, E1008, E1009, E1010, E1011, E1012, E1014, E1015, E1016, E1017, E1018, E1020, E1028, E1029, E1030, E1031, E1037, E1038, E1039, E1161, E1225, E1226, E1229, E1231, E1232, E1233, E1234, E1235, E1236, E1237, E1238, E2201, E2202, E2203, E2204, E2205, E2206, E2207, E2210, E2211, E2213, E2214, E2216, E2217, E2218, E2219, E2220, E2221, E2222, E2224, E2225, E2226, E2227, E2228, E2230, E2295, E2300, E2301, E2310, E2311, E2312, E2313, E2321, E2322, E2323, E2325, E2326, E2327, E2328, E2329, E2330, E2331, E2351, E2358, E2359, E2360, E2361, E2362, E2363, E2364, E2365, E2366, E2367, E2368, E2369, E2370, E2371, E2372, E2373, E2374, E2375, E2376, E2377, E2378, E2381, E2382, E2383, E2384, E2385, E2386, E2387, E2388, E2389, E2390, E2391, E2392, E2394, E2395, E2396, E2397, E2398, E2605, E2606, E2607, E2608, E2609, E2613, E2614, E2615, E2616, E2617, E2620, E2621, E2622, E2623, E2624, E2625, E2626, E2627, E2628, E2629, E2630, E2631, E2633, K0001, K0002, K0003, K0004, K0005, K0006, K0007, K0009, K0015, K0017, K0018, K0019, K0020, K0037, K0038, K0039, K0040, K0041, K0042, K0043, K0044, K0045, K0046, K0047, K0050, K0051, K0052, K0053, K0069, K0070, K0071, K0072, K0077, K0098, K0108, K0195, K0733, K0800, K0801, K0802, K0806, K0807, K0808, K0812, K0813, K0814, K0815, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0828, K0829, K0830, K0831, K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843, K0848, K0849, K0850, K0851, K0852, K0853, K0854, K0855, K0856, K0857, K0858, K0859, K0860, K0861, K0862, K0863, K0864, K0868, K0869, K0870, K0871, K0877, K0878, K0879, K0880, K0884, K0885, K0886, K0890, K0891, K0900."
Wheelchair Seating – Oxford Clinical Policy
Effective Date: 06.01.2022 – This policy addresses wheelchair seating. Applicable Procedure Codes: E0953, E0955, E0956, E0957, E0960, E0966, E0992, E1028, E2231, E2291, E2292, E2293, E2294, E2601, E2602, E2603, E2604, E2605, E2606, E2607, E2608, E2609, E2610, E2611, E2612, E2613, E2614, E2615, E2616, E2617, E2619, E2620, E2621, E2622, E2623, E2624, E2625, K0108, K0669.
Whole Exome and Whole Genome Sequencing – Oxford Clinical Policy
Effective Date: 03.01.2022 – This policy addresses whole exome and whole genome sequencing. Applicable Procedure Codes: 0012U, 0013U, 0014U, 0036U, 0094U, 0212U, 0213U, 0214U, 0215U, 0265U, 81415, 81416, 81417, 81425, 81426, 81427.
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text:
Ashraf H. A. Rushdy's "American Lynching"
Ashraf H. A. Rushdy is professor of African American studies at Wesleyan University. He is the author of The Empty Garden: The Subject of Late Milton; Neo-Slave Narratives: Studies in the Social Logic of a Literary Form; and Remembering Generations: Race and Family in Contemporary African American Fiction.
He applied the "Page 99 Test" to his latest book, American Lynching, and reported the following:
Page 99 of American Lynching consists of a long paragraph in a chapter devoted to disentangling what I call the "discourse of lynching" that rose to prominence after the 1880s. This "discourse" is the product of pro-lynching advocates who claimed that lynching was performed as a punishment for rape, and African American intellectuals and anti-lynching activists like Frederick Douglass and Ida B. Wells energetically contested it, exposed its logical flaws, and revealed to what startling extent it did not square with the known facts about lynching in turn of the century America. The paragraph on page 99 sums up the inchoate forms of that discourse prior to the 1880s, attending especially to the ways that "rape" assumed the status of the bloody shirt in that discourse.
It is a paragraph that assumes an important place in the logical argument I am making, which is to show how the discourse of the 1880s was formed from earlier rationales and excuses, and to delineate just what made it so forceful and appealing to those who defended lynchings. I would then turn to the devastating critique offered by Douglass and Wells and others. My larger point was to show how this discourse had assumed an inordinately influential place in our national imagination, how it had in fact continued to play a significant role in thinking about lynching and racial violence well into the 1970s and after. Because in the book as a whole I argue for the important continuities in lynching in America, I had to explain how certain ways of thinking and talking about lynching had played a role in delimiting the definition of what was and wasn't a lynching. The chapter on the discourse of lynching argued that we had to examine how that discourse emerged, evolved, and assumed the form it did so that we could better appreciate the continuity between the late-nineteenth century ritual, spectacle lynchings and those acts of collective extralegal execution sanctioned and performed by Americans from before the Revolutionary War.
So, is the Page 99 test accurate for my book? Well, I guess the "quality of the whole" is revealed in it since the book as a whole is interpretive, and, like this paragraph, made up of connected arguments that reveal the intellectual and social evolutions and continuities in the historical phenomenon.
Here we see what would become the stark gendered dynamics of the lynching discourse, which represented lynching as a patently patriarchal practice, a defense by men of women, through violence. In later forms, primarily during and after the 1870s, the discourse of lynching will straightforwardly state that those who lynch are protectors of women and those who are lynched debauchers of them (and, of course, "women" in that discourse always could mean only "white"). It is notable that one of the earliest defenses of lynching also used the language of rape, and even more notable that the crime the lynchers punished was so obviously not rape. This apparent anomaly demonstrates the ways that the rhetoric of rape was used to register the most offensive type of crime, one for which there was no defense. Someone could murder in self-defense, could perhaps be driven to theft by hunger, but nothing could justify rape. Moreover, rape was seen to be worse than either murder or theft. While theft could be seen as an abstraction, to an extent, and not irreversible (property can be returned), rape was neither; in the terms of the debate over it, rape rendered the raped woman irredeemable and stole from her (and, in patriarchal values, her father or husband) something that was lost forever. It was common for lynching advocates to claim that rape was worse than murder because it assaulted the soul as well as the body of the victim, not a surprising rhetorical strategy in a patriarchal culture where a woman was valued for her capacity to deliver an honest heir, where centuries of religious scripture and secular writers celebrated chastity as a greater possession than life, for a woman. Finally, rape, according to the patriarchal dictates that governed the understanding of the crime, was perceived to be a crime against family, that haven in a heartless world, and one to which any man with a family was therefore susceptible. It was a crime without any means of defense, a crime that left the victim worse than dead, and one that struck close to the heart of any man with a mother or wife or daughter. In the midst of a culture holding such values, it was obvious how effective the rhetoric of rape could be, no matter what the crime. It was a metaphor for the nadir of human debasement. It was also a charge that was, in the words of British Lord Chief Justice Matthew Hale, "easily to be made and hard to be proved, and harder to be defended."
Learn more about American Lynching at the Yale University Press website.
Glen Pettigrove's "Forgiveness and Love"
Paul Thomas Chamberlin's "The Global Offensive"
Eric Jay Dolin's "When America First Met China"
Thomas K. McCraw's "The Founders and Finance"
David J. Hess's "Good Green Jobs in a Global Econo...
Ronald Hendel's "The Book of 'Genesis': A Biograph...
Simon Read's "Human Game"
Lucia McMahon's "Mere Equals"
Michael Neiberg's "The Blood of Free Men"
Sten Rynning's "NATO in Afghanistan"
Douglas Smith's "Former People"
Timothy F. Murphy's "Ethics, Sexual Orientation, a...
Adriana Páramo's "Looking for Esperanza"
Nancy C. Unger's "Beyond Nature's Housekeepers"
Emily W. Kane's "The Gender Trap"
Avi Raz's "The Bride and the Dowry"
Malcolm Barber's "The Crusader States"
Evelyn Alsultany's "Arabs and Muslims in the Media...
Jo Applin's "Eccentric Objects: Rethinking Sculptu...
George Cotkin's "Dive Deeper"
Tanya Katerí Hernández's "Racial Subordination in ...
Kevin Mattson's "Just Plain Dick"
Beth Tompkins Bates's "The Making of Black Detroit...
Robyn Arianrhod's "Seduced by Logic"
John Shelton Reed's "Dixie Bohemia"
John A. Long's "The Dawn of the Deed"
Mathias Risse's "On Global Justice"
Richard Huzzey's "Freedom Burning"

redpajama_set_name: RedPajamaCommonCrawl


text:
Bundesliga Review – Week 20
It has been, in the words of Manuel Baum, an "extraordinary" week for Augsburg. It all started after their 2-0 defeat at Borussia Mönchengladbach last weekend. Having gone three months without tasting victory that was to be expected against the high-flying Foals. But for one, it was the final straw.
"The whole year 2018 shows the curve down, I do not see much improvement, the development goes down for a year," said Martin Hinteregger, Augsburg's outspoken but steady rock at the heart of their defence. At least he was. One week later, he was wearing the unfamiliar black of Eintracht Frankfurt, helping the Eagles to a point against leaders Borussia Dortmund.
His Augsburg career was as good as over by the time he finished that interview with local media. Not many players can come back from speaking out publically against their coach. "I cannot say anything positive about him and will say nothing negative," he said of Baum, a choice of words that left little doubt about what he really wanted to say.
The club moved to issue a fine and ban him from training with the rest of the team, and with the transfer window still open, it was never likely they would reject any offers that came their way. Frankfurt made their move, and although it is for now only a loan move, it is safe to say Hinteregger won't play for Augsburg again.
There have been suggestions that the defender's comments were designed to force a move. Whatever the intentions, it was clear he was no longer wanted. "Right now we need players who live the values and rules of the club, who fully identify with the club, people who are with us with their hearts," said Baum ahead of their game against Mainz. Although he didn't say so, that was obviously a swipe at Hinteregger, and perhaps also Caiuby too.
The Brazilian, much like Hinteregger a key figure for die Fuggerstädterin recent years, also appears to have no future. For the second time in less than a year, he has gone AWOL, having done so in the summer as well. There may be legitimate personal reasons for his decision to remain in Brazil rather than return as he should have done with Augsburg, but as far as the club is concerned, enough was enough. He too has been banished and told to find a new club.
As they took the field in the snow at the WWK-Arena on Sunday, their situation was definitely precarious. No wins in ten and three defeats in a row left them just a point above the bottom three, they were in the thick of the relegation battle. And now they had to fight without two of their previously most important players.
Baum has been publically backed by the club, not in least in their handling of Hinteregger, and he had reinforcements for this game. The high-profile employment of Jens Lehmann as an assistant coach has almost been a sideshow to the other goings on, ostensibly to reinforce his authority. Also on the bench was Reece Oxford, back in the Bundesliga having failed again to break into the West Ham United side after his previous spell on loan with Gladbach, whilst Ji Dong-won, in the starting line-up, and Koo Ja-Cheol were back from the Asian Cup.
Baum and Augsburg also had luck on their side. Mainz, without the suspended Stefan Bell, did not look up for the game. Daniel Brosinski was very unlucky to concede a penalty when a Ji Dong-won cross bounced off his chest into his arm, but Moussa Niakhaté only had himself to blame when a VAR check confirmed his out-stretched hand made contact with the ball. Two penalties for Augsburg, two goals for Alfreð Finnbogason.
Others leaders were rising out of the snow. Ji showed few signs of fatigue as he helped to run the show. Finnbogason completed his hat-trick too, combining superbly with Michael Gregoritsch and Jan Morávek in the build-up. After that, they could just coast their way through the second half, Mainz offering very little threat. After the week they've had, they could not have asked for an easier assignment.
"We said before the game that it is a great opportunity for us to show the team's character and you have seen that today," a pleased, and perhaps slightly relieved, Baum said after the match. "'Augsburg sticks together' is not just a saying, but is impressively lived."
His players had presented a united front, both on and off the pitch. "It was very important that we played as a team," said hat-trick hero Finnbogason. "Behind us is a hectic week, everyone has been waiting for our answer on the pitch." Daniel Baier and Gregoritsch also said there were happy to have done the talking pitch.
There is still an awfully long way for them to go. It remains to be seen if this is a freak result – they had already beaten Mainz in the DFB-Pokal since their last league victory at Hannover in October – or if the galvanising experience of the "most turbulent week in their Bundesliga history" (Kicker) can lead Baum's men back up the German top tree.
1 | Borussia Dortmund extended their lead at the top of the Bundesliga to seven points despite picking up just a draw at Eintracht Frankfurt. Marco Reus & Co. could well have seen themselves 11 points clear of Borussia Mönchengladbach and Bayern Munich had they taken their chances. Reus on another day would have had a hat-trick within five minutes but the main thing for Lucien Favre's side is their performance didn't drop – Eintracht Frankfurt just matched them. Morale in Dortmund at the minute is certainly high, especially after the Bayer Leverkusen score popped up on the big screen at the Commerzbank Arena, of which cameras panned to Axel Witsel, who couldn't keep a straight face.
2 | With Bayern Munich's 3-1 defeat at Bayer Leverkusen, Borussia Mönchengladbach had the chance to leapfrog Niko Kovač's side into second. And that they did. Perhaps not their most convincing win but three points nonetheless. They matched Schalke on Saturday evening and finally took their chances with late goals from Christoph Kramer and Florian Neahaus. This season we do truly have a title race on our hands and it's important to remember that Gladbach has just a big of a chance as Bayern do to clinch a Bundesliga title. Dieter Hecking has got them playing some impressive, free-flowing, attacking football.
3 | Hosting RB Leipzig on Friday night, Thomas Doll couldn't have asked for a worse start. Although they started off defensively sound, RB Leipzig soon picked them apart which sees them still rooted to the foot of the Bundesliga. Already seven points behind guaranteed safety, it's going to be a huge task for Die Roten, especially with the injury to last season's top scorer, Niclas Füllkrug.
By James Rees with Daniel Pinder.


text:
The following are the golfers who have won a PGA Tour event at least five times.

Source:  Official website
Notability:

Multiple winners
The following golfers have won more than one event at least five times.

7 events
Tiger Woods (WGC-Bridgestone Invitational, WGC-Cadillac Championship, Farmers Insurance Open, Arnold Palmer Invitational, BMW Championship, Memorial Tournament, Masters Tournament)

3 events
Sam Snead (Greater Greensboro Open, Miami Open, Goodall Palm Beach Round Robin)
Jack Nicklaus (Masters Tournament, Tournament of Champions, PGA Championship)

2 events
Walter Hagen (Western Open, PGA Championship)

References

PGA Tour
P

redpajama_set_name: RedPajamaWikipedia


text:
Home News Archives Autopsy: Willard Scott Was Shot In The Back by Trooper
Autopsy: Willard Scott Was Shot In The Back by Trooper
by Sarah Willets
Thomasine Hinson
Willard Scott
Two days after the family of Willard Scott Jr. demanded answers in the thirty-one-year-old's death, an autopsy report has been released showing he was shot in the back by a highway patrolman.
Scott was killed February 12 after Trooper Jerimy Mathis attempted to pull him over on Duke Street for driving erratically. The trooper pursued Scott's vehicle and when Scott got out of the car and ran, Mathis chased him on foot before firing at Scott. A gun that did not belong to the Highway Patrol was found at the scene.
The autopsy shows Scott was shot in the left lower back and the right buttock. The report says he suffered "a major aortic injury with massive blood loss" and died during an operation.
The Durham NAACP, in a statement on behalf of Scott's family, says the news that Scott had been shot in the back multiple times confirms "our worst fears."
"While today's autopsy provides us with some answers about what happened the evening that NC Highway Patrolman Jeremy Mathis killed Willard Scott, the answers lead to even more questions," the statement says.
Through the Durham NAACP, the family continued its call for a thorough and transparent investigation of the shooting, the release any relevant video, audio or other documents to the family, and for the state Highway Patrol to train troopers in de-escalation.
"We must have accountability of the actions of law enforcement officers," the statement says. "Accountability is the only way to stop these killings all across the country. As long as officers are being let off the hook in each case, the next officer will think they can get away with it too."
Scott's family members gathered Saturday at the Durham County court house to ask for the release of the autopsy after weeks of organizing call-ins to the medical examiner's office. They said they were not told why the exam took more than one hundred and forty days to be released, only that it would be released "soon."
"My baby is gone," said Scott's mother, Thomasine Hinson. "What can be done to honor Junior? We have one simple request: Justice."
Durham police shooting Willard Scott NAACP Issue: 2017-07-05 Blogs News


Version 4.0 is a major new release. We've created a convenient migration guide to make upgrading as simple as possible.
The biggest news is that PSPDFKit is now fully compatible with iOS 8 and requires Xcode 6 with SDK 8. There have been a lot of changes, updating everything was a lot of effort. We still support iOS 7 but dropped iOS 6 and updated many places in the code to use more modern API calls, to better future-proof the product. Following Apple's new defaults, we removed the slice for armv7s and ship the binary with all platforms Apple supports (armv7, arm64, i386 and x86_64).
We've added @3x resources for all assets to provide a crisp and clear look on the new iPhone 6 Plus which has an even higher pixel density.
Several properties that were no longer in line with iOS 7 have been removed: tintColor, shouldTintPopovers and minLeft/RightToolbarWidth. Use UIAppearance to customize colors and tint throughout PSPDFKit instead. An important change is that we no longer support the legacy UIViewControllerBasedStatusBarAppearance setting. Use view controller based status bar appearance instead. We've also switched to NSURLSession internally, which enables SPDY support for faster asset fetching (if your server supports that).
Part of the API cleaning was the introduction of a new immutable configuration object that unifies most of the possible settings in PSPPDFKit. This makes customizing a lot simpler, plus PSPDFConfiguration itself can be stored so different configurations can be applied easily. See our PSPDFCatalog for many samples how to use it. The pattern we use here is called the "builder pattern" and you'll find that in modern Apple API such as WKWebView as well.
Previously, there were some limitations for unusual document formats, specifically a limitation for super long/wide PDFs. This has been removed. PSPDFKit now correctly renders documents no matter how long they are - we tested documents up to 5000px long/500px wide. There are many other tweaks as well, including lazy evaluation of embedded videos so they don't block the page display.
The thumbnail bar now automatically groups pages if the thumbnailGrouping setting is enabled - this is great for magazines and content that is optimized for two-page-display.
Outline elements defined in the PDF can contain font and color information. We now correctly parse and display such informations to ensure your document is displayed just as it would be in Acrobat.
PSPDFLibrary now allows you to preview text based on the FTS index.
Annotation hit testing now works on paths directly, which allows better selection in cases where multiple annotations are overlaid. Chances it simply does "the right thing" are a lot higher now. There's also a new dialog which asks for the default username so we correctly can write this when storing data in the PDF. We try hard to pick a useful default, but you can of course customize or disable this.
We support cloud annotation borders. There's no UI to create them yet, but documents which are configured to render clouds will correctly display in PSPDFKit as well. Callouts are a special subtype of free text annotations, and we support them now as well.
The API around digital signatures has been completely updated, the new architecture allows connecting external PKI hardware for the signing process.
Many UI widgets have been updated to support the new iOS 8 keyboards with non-standard heights. Sharing content via iMessage is now built-in. Embedded videos are now autostarted if this is configured in the PDF (we support the ActivationContext settings now for RichMedia objects). And there are a ton of performance improvements and of course many bug fixes.


Two fantastic stories out this week – both in Woman's Own! Firstly we have the real life Rapunzel Keeley, who grew her hair super long twice, so she could cut it off to help other children. And secondly, the inspirational stories of Sadie, Jojo and Heather, three women who left behind the rat race for a new life in far away lands.
Pick up a copy of this week's Woman's Own to see our stars shining.
If you have a story you'd like to sell, of how you escaped the rat race to do something unusual with your life, or perhaps your daughter, like Keeley, went above and beyond to help others, then we'd like to hear from you.