Anthem BCBS Medical Policy Updates – July 2022

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

July 2022 Anthem BCBS Medical Policy Updates:

• Ablative Techniques as a Treatment for Barrett’s Esophagus
• Advanced Lipoprotein Testing
• Alcohol Septal Ablation for Treatment of Hypertrophic Cardiomyopathy
• Altered Auditory Feedback Devices for the Treatment of Stuttering
• Ambulance Services: Ground; Non-Emergent
• Angiographic Evaluation and Endovascular Intervention for Dialysis Access Circuit Dysfunction
• Assistant Surgeons
• Auditory Brainstem Responses (ABRs) and Evoked Otoacoustic Emissions (OAEs) for Hearing Disorders
• Axial Lumbar Interbody Fusion
• Balloon Sinus Ostial Dilation
• Bicompartmental Knee Arthroplasty
• Bioimpedance Spectroscopy Devices for the Detection and Management of Lymphedema
• Biomagnetic Therapy
• Bone-Anchored and Bone Conduction Hearing Aids
• Bronchial Gene Expression Classification for the Diagnostic Evaluation of Lung Cancer
• Bronchial Thermoplasty
• Cardiac Stress Testing with Electrocardiogram
• Cell-free DNA Testing to Aid in the Monitoring of Kidney Transplants for Rejection
• Cervical Traction Devices for Home Use
• Chromosomal Microarray Analysis (CMA) for Developmental Delay, Autism Spectrum Disorder, Intellectual Disability (Intellectual Developmental Disorder) and Congenital Anomalies
• Clinical Utilization Management (UM) Guideline for Pre-Payment Review Medical Necessity Determinations When No Other Clinical UM Guideline Exists
• Cochlear Implants and Auditory Brainstem Implants
• Cooling Devices and Combined Cooling/Heating Devices
• Cosmetic and Reconstructive Services of the Trunk and Groin
• Cosmetic and Reconstructive Services: Skin Related
• Cryoneurolysifor Treatment of Peripheral Nerve Pain
• Cryosurgical or Radiofrequency Ablation to Treat Solid Tumors Outside the Liver
• Diagnostic Fiberoptic Flexible Laryngoscopy
• Diagnostic Infertility Surgery
• Donor Lymphocyte Infusion for Hematologic Malignancies after Allogeneic Hematopoietic Progenitor Cell Transplantation
• Doppler-Guided Transanal Hemorrhoidal Dearterialization
• Dynamic Low-Load Prolonged-Duration Stretch Devices
• Dynamic Spinal Visualization (Including Digital Motion X-ray and Cineradiography/ Videofluoroscopy)
• Electric Breast Pumps
• Electrical Nerve Stimulation, Transcutaneous, Percutaneous
• Electronic Positional Devices for the Treatment of Obstructive Sleep Apnea
• Extracorporeal Shock Wave Therapy
• Eye Movement Analysis Using Non-spatial Calibration for the Diagnosis of Concussion
• Fecal Analysis in the Diagnosis of Intestinal Disorders
• Functional Endoscopic Sinus Surgery (FESS)
• Gender Reassignment Surgery
• Gene Expression Profiling for Idiopathic Pulmonary Fibrosis
• Gene Expression Profiling for Managing Breast Cancer Treatment
• Gene Expression Profiling of Melanomas
• Genetic Testing to Confirm the Identity of Laboratory Specimens
• Genotype Testing for Individual Genetic Polymorphisms to Determine Drug-Metabolizer Status
• Hematopoietic Stem Cell Transplantation for Autoimmune Disease and Miscellaneous Solid Tumors
• High Resolution Anoscopy Screening for Anal Intraepithelial Neoplasia (AIN) and SquamouCell Cancer of the Anus
• Hip Resurfacing
• Home Parenteral Nutrition
• Hospital Beds and Accessories
• Hyperoxemic Reperfusion Therapy
• Immunizations
• Implantable Ambulatory Event Monitors and Mobile Cardiac Telemetry
• Implantable Middle Ear Hearing Aids
• Infant Home Apnea Monitors
• Ingestion Event Monitors
• Injection Treatment for Morton’s Neuroma
• Inpatient Admission for Radiation Therapy for Cervical or Thyroid Cancer
• Internal Rib Fixation Systems
• InterspinouProcesFixation Devices
• Intracytoplasmic Sperm Injection (ICSI)
• Intrapulmonary Percussive Ventilation Devices for Airway Clearance
• Investigational Criteria
• Irreversible Electroporation
• Ketogenic Diet for Treatment of Intractable Seizures
• Machine Learning Derived Probability Score for Rapid Kidney Function Decline
• Magnetic Source Imaging and Magnetoencephalography
• Magnetization-Prepared Rapid Acquisition Gradient Echo Magnetic Resonance Imaging (MPRAGE MRI)
• Mandibular/Maxillary (Orthognathic) Surgery
• Maze Procedure
• Mechanical Circulatory Assist Device(Ventricular Assist Devices, PercutaneouVentricular Assist Deviceand Artificial Hearts)
• Medical Necessity Criteria
• Microprocessor Controlled Lower Limb Prosthesis
• Moderate to Deep Anesthesia Services for Dental Surgery in the Facility Setting
• Molecular Marker Evaluation of Thyroid Nodules
• Multi-biomarker Disease Activity Blood Tests for Rheumatoid Arthritis
• Nasal Surgery for the Treatment of Obstructive Sleep Apnea and Snoring
• Nerve Graft after Prostatectomy
• Neuromuscular Stimulation in the Treatment of Muscle Atrophy
• Noninvasive Home Ventilator Therapy for Respiratory Failure
• Open Sacroiliac Joint Fusion
• Oral, Pharyngeal and Maxillofacial Surgical Treatment for Obstructive Sleep Apnea or Snoring
• Orthopedic Footwear
• Outpatient Cystourethroscopy
• Panel and other Multi-Gene Testinfor Polymorphisms to Determine Drug-Metabolizer Status
• Parenteral Antibiotics for the Treatment of Lyme Disease
• Partial Left Ventriculectomy
• Pediatric Gait Trainers
• Penile Prosthesis Implantation
• Percutaneouand Endoscopic Spinal Surgery
• Perirectal Spacerfor Use During Prostate Radiotherapy
• Pneumatic Compression Devices for Prevention of Deep Vein Thrombosis of the Extremities in the Home Setting
• Powered Robotic Lower Body Exoskeleton Devices
• Preventive Health Guidelines
• Prostate Biopsy using MRI Fusion Techniques
• Pulmonary Rehabilitation
• Radiofrequency and Pulsed Radiofrequency Treatment of Trigger Point Pain
• Radiofrequency Neurolysis and Pulsed Radiofrequency Therapy for Trigeminal Neuralgia
• Reduction Mammaplasty
• Rupture of Membranes Testing in Pregnancy
• Sacral Nerve Stimulation and Percutaneous Tibial Nerve Stimulation for Urinary and Fecal Incontinence; Urinary Retention
• Sacral Nerve Stimulation as a Treatment of Neurogenic Bladder Secondary to Spinal Cord Injury
• Selected Blood, Serum and Cellular Allergy and Toxicity Tests
• Standing Frames
• Static Progressive Stretch (SPS) and Patient-Actuated Serial Stretch (PASS) Devices
• Surgical Treatment for Dupuytren’s Contracture
• Synthetic Cartilage Implant for Metatarsophalangeal Joint Disorders
• Technologies for the Evaluation of Skin Lesions (including Dermatoscopy, Epiluminescence Microscopy, Videomicroscopy and Ultrasonography)
• Testing for Oral and Esophageal Cancer
• THE Electrophysiology-Guided Noninvasive Stereotactic Cardiac Radioablation
• Transendoscopic Therapy for Gastroesophageal Reflux Disease, Dysphagia and Gastroparesis
• Treatment of Keloids and Scar Revision
• Treatment of Varicose Vein (Lower Extremities)
• Trigger Point Injections
• Ultrasound Bone Growth Stimulation
• Upper Extremity Myoelectric Orthoses
• Vagus Nerve Stimulation
• Vena Cava Filters
• Vertebral Body Stapling and Tethering for the Treatment of Scoliosiin Children and Adolescents
• Vertical Expandable Prosthetic Titanium Rib
• Viscocanalostomy and Canaloplasty
• Wireless Capsule Endoscopy for Gastrointestinal Imaging and the Patency Capsule
• Wireless Capsule for the Evaluation of Suspected Gastric and Intestinal Motility Disorders

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

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Anthem BCBS

Anthem BCBS