Anthem BCBS Medical Policy Updates – April 2021

Click here to view the Anthem Blue Cross Blue Shield Medical Policy Updates »

 April Anthem BCBS 2021 Medical Policy Updates:

• Adenoidectomy
• Adipose-derived Regenerative Cell Therapy and Soft Tissue Augmentation Procedures
• Adoptive Immunotherapy and Cellular Therapy
• Allergy Immunotherapy (Subcutaneous)
• Analysis of Proteomic Patterns
• Artificial Retinal Devices
• Automated External Defibrillators for Home Use
• Autonomic Testing
• Balloon Dilation of the Eustachian Tubes
• BCR-ABL Mutation Analysis
• Biofeedback and Neurofeedback
• Bioimpedance Spectroscopy Devices for the Detection and Management of Lymphedema
• Blepharoplasty, Blepharoptosis Repair, and Brow Lift
• Bone-Anchored and Bone Conduction Hearing Aids
• BRCA Testing for Breast and/or Ovarian Cancer Syndrome
• Breast Procedures; including Reconstructive Surgery, Implants and Other Breast Procedures
• Cardioverter Defibrillators
• Carotid Sinus Baroreceptor Stimulation Devices
• Carotid, Vertebral and Intracranial Artery Stent Placement with or without Angioplasty
• Catheter-based Embolization Procedures for Malignant Lesions Outside the Liver
• Cell-free DNA Testing to Aid in the Monitoring of Kidney Transplants for Rejection
• Cervical Cancer Screening Using Cytology and Human Papillomavirus Testing
• Cervical Cancer Screening Using Cytology and Human Papillomavirus Testing
• Circulating Tumor DNA Testing for Cancer (Liquid Biopsy)
• Circulating Tumor DNA Testing for Cancer (Liquid Biopsy)
• Computed Tomography to Detect Coronary Artery Calcification
• Continuous Monitoring of Intraocular Pressure
• Cosmetic and Reconstructive Services of the Head and Neck
• Cosmetic and Reconstructive Services of the Trunk and Groin
• Cosmetic and Reconstructive Services: Skin Related
• Cranial Remodeling Bands and Helmets (Cranial Orthotics)
• Detection and Quantification of Tumor DNA Using Next Generation Sequencing in Lymphoid Cancers
• Detection of Circulating Tumor Cells in the Blood as a Prognostic Factor for Cancer
• Drug-Eluting Devices for Maintaining Sinus Ostial Patency
• Electronic Home Visual Field Monitoring
• Electrothermal Shrinkage of Joint Capsules, Ligaments, and Tendons
• Focal Laser Ablation for the Treatment of Prostate Cancer
• Focused Microwave Thermotherapy for Breast Cancer
• Functional Electrical Stimulation (FES); Threshold Electrical Stimulation (TES)
• Fundus Photography
• Gene Expression Profiling for Bladder Cancer
• Gene Expression Profiling for Coronary Artery Disease
• Gene Expression Profiling for Managing Breast Cancer Treatment
• Gene Mutation Testing for Solid Tumor Cancer Susceptibility and Management
• Gene Therapy for Ocular Conditions
• Gene-Based Tests for Screening, Detection and Management of Prostate Cancer
• Genetic Testing for CHARGE Syndrome
• Genetic Testing for Heritable Cardiac Conditions
• Genetic Testing for Inherited Diseases
• Genetic Testing for Lynch Syndrome, Familial Adenomatous Polyposis (FAP), Attenuated FAP and MYH-associated Polyposis
• Genetic Testing for PTEN Hamartoma Tumor Syndrome
• Genetic Testing for PTEN Hamartoma Tumor Syndrome
• Genetic Testing for Statin-Induced Myopathy
• Genetic Testing for TP53 Mutations
• Genotype Testing for Individual Genetic Polymorphisms to Determine Drug-Metabolizer Status
• Hematopoietic Stem Cell Transplantation for Autoimmune Disease and Miscellaneous Solid Tumors
• Hematopoietic Stem Cell Transplantation for Hodgkin Disease and non-Hodgkin Lymphoma
• Hyperthermia for Cancer Therapy
• Idiopathic Environmental Illness (IEI)
• Imaging Techniques for Screening and Identification of Cervical Cancer
• In Vitro Chemosensitivity Assays and In Vitro Chemoresistance Assays
• Intensive Programs for Pediatric Feeding Disorders
• Intervertebral Stabilization Devices
• Intracardiac Ischemia Monitoring
• Intraocular Anterior Segment Aqueous Drainage Devices (without extraocular reservoir)
• Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery with Radiofrequency Spectroscopy or Optical Coherence Tomography
• Intraoperative Neurophysiological Monitoring
• Janus Kinase 2, CALR and MPL Gene Mutation Assays
• Kidney Transplantation
• Laboratory Testing as an Aid in the Diagnosis of Heart Transplant Rejection
• Laboratory Testing as an Aid in the Diagnosis of Heart Transplant Rejection
• Leadless Pacemaker
• Locoregional and Surgical Techniques for Treating Primary and Metastatic Liver Malignancies
• Low Intensity Therapeutic Ultrasound for the Treatment of Pain
• Lysis of Epidural Adhesions
• Magnetic Resonance Neurography
• Mandibular/Maxillary (Orthognathic) Surgery
• Mastectomy for Gynecomastia
• Microprocessor Controlled Lower Limb Prosthesis
• Microsurgical Procedures for the Treatment of Lymphedema
• Mobile Device-Based Health Management Applications
• Molecular Gastrointestinal Pathogen Panel (GIPP) Testing for Infectious Diarrhea in the Outpatient Setting
• Molecular Marker Evaluation of Thyroid Nodules
• Monitored Anesthesia Care for Gastrointestinal Endoscopic Procedures
• MRI Guided High Intensity Focused Ultrasound Ablation for Non-Oncologic Indications
• Myoelectric Prosthesis
• Myringotomy and Tympanostomy Tube Insertion
• Neonatal Levels of Care
• Neonatal Levels of Care
• Non-invasive Measurement of Advanced Glycation Endproducts (AGEs) in the Skin
• Non-Invasive Measurement of Left Ventricular End Diastolic Pressure in the Outpatient Setting
• or 5-D Ultrasound in Maternity Care
• Paired DNA and Messenger RNA (mRNA) Genetic Testing to Detect, Diagnose and Manage Cancer
• Pancreas Transplantation and Pancreas Kidney Transplantation
• Panniculectomy and Abdominoplasty
• Patent Foramen Ovale and Left Atrial Appendage Closure Devices for Stroke Prevention
• Percutaneous Ultrasonic Ablation of Soft Tissue
• Perirectal Spacers for Use During Prostate Radiotherapy
• Photocoagulation of Macular Drusen
• Physiologic Recording of Tremor using Accelerometer(s) and Gyroscope(s)
• Pneumatic Compression Devices for Lymphedema
• Pooled Antibiotic Sensitivity Testing
• Positional MRI
• Prefabricated and Prophylactic Knee Braces
• Preimplantation Genetic Diagnosis Testing
• Prenatal Testing
• Presbyopia and Astigmatism-Correcting Intraocular Lenses
• Prostate Saturation Biopsy
• Protein Biomarkers for the Screening, Detection and Management of Prostate Cancer
• Reduction Mammaplasty
• Respiratory Viral Panel Testing in the Outpatient Setting
• RET Proto-oncogene Testing for Endocrine Gland Cancer Susceptibility
• RET Proto-oncogene Testing for Endocrine Gland Cancer Susceptibility
• Retinal Telescreening Systems
• Sacral Nerve Stimulation and Percutaneous Tibial Nerve Stimulation for Urinary and Fecal Incontinence; Urinary Retention
• Sacral Nerve Stimulation and Percutaneous Tibial Nerve Stimulation for Urinary and Fecal Incontinence; Urinary Retention
• Sacroiliac Joint Fusion
• Scrotal Ultrasound
• Self-Expanding Absorptive Sinus Ostial Dilation
• Sensory Stimulation for Brain-Injured Individuals in Coma or Vegetative State
• Septoplasty
• Small Bowel, Small Bowel/Liver and Multivisceral Transplantation
• Spectral Analysis of Prostate Tissue by Fluorescence Spectroscopy
• Stereotactic Radiofrequency Pallidotomy
• Surgical and Ablative Treatments for Chronic Headaches
• Surgical and Minimally Invasive Treatments for Benign Prostatic Hyperplasia (BPH)
• Temporomandibular Disorders
• Therapeutic Apheresis
• Therapeutic Shoes, Inserts or Modifications for Individuals with Diabetes
• (TLSO), Lumbar-Sacral (LSO), and Lumbar
• Tonsillectomy for Children with or without Adenoidectomy
• Topographic Genotyping
• Transanal Radiofrequency Treatment of Fecal Incontinence
• Transrectal Ultrasonography
• Treatment of Keloids and Scar Revision
• Ultrafiltration in Decompensated Heart Failure
• Umbilical Cord Blood Progenitor Cell Collection, Storage and Transplantation
• Unicondylar Interpositional Spacer
• Upper Extremity Myoelectric Orthoses
• Upper Gastrointestinal Endoscopy in Adults
• Uterine Transplantation
• Vagus Nerve Stimulation
• Visual, Somatosensory and Motor Evoked Potentials
• Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling
• Wireless Capsule Endoscopy for Gastrointestinal Imaging and the Patency Capsule
• Wireless Cardiac Resynchronization Therapy for Left Ventricular Pacing

Click here to view the Anthem Blue Cross Blue Shield Medical Policy Updates »

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