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Anthem BCBS Medical Policy Updates – October 2024
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Click here to view the Anthem BCBS Blue Cross Blue Shield Medical Policy Updates »
October 2024 Anthem BCBS Medical Policy Updates:
- Absolute Quantitation of Myocardial Blood Flow Measurement
- Allogeneic Xenographic Synthetic Bioengineered and Composite Products for Wound Healing and Soft Tissue Grafting
- Anesthesia Services for Interventional Pain Management Procedures
- Ankle-Foot & Knee-Ankle-Foot Orthoses
- Artificial Intelligence-Based Software for Prostate Cancer Detection
- Augmentative and Alternative Communication (AAC) Devices with Digitized or Synthesized Speech Output
- Autologous and Allogeneic Pancreatic Islet Cell Transplantation
- Automated Evacuation of Meibomian Gland
- Automated External Defibrillators for Home Use
- Automated Insulin Delivery Systems
- Back-Up Ventilators in the Home Setting
- Balloon Dilation of the Eustachian Tubes
- Bariatric Surgery and Other Treatments for Clinically Severe Obesity
- Bone Mineral Density Testing Measurement
- Brain Computer Interface Rehabilitation Devices
- Breast Procedures including Reconstructive Surgery Implants and Other Breast Procedures
- Cancer Antigen 125 Testing
- Cancer Antigen 19-9 Testing
- Carcinoembryonic Antigen Testing
- Cardiac Contractility Modulation Therapy
- Cardiac Electrophysiological Studies (EPS) and Catheter Ablation
- Carotid Vertebral and Intracranial Artery Stent Placement with or without Angioplasty
- Cataract Removal Surgery for Adults
- Cellular Therapy Products for Allogeneic Stem Cell Transplantation
- Cervical Cancer Screening Using Cytology and Human Papillomavirus Testing
- Coblation Therapies for Musculoskeletal Conditions
- Colonoscopy
- Continuous Glucose Monitoring Devices and External Insulin Infusion Pumps
- Continuous Local Delivery of Analgesia to Operative Sites using an Elastomeric Infusion Pump during the Post-Operative Period
- Cryopreservation of Oocytes or Ovarian Tissue
- Cryosurgical Radiofrequency or Laser Ablation to Treat Solid Tumors Outside the Liver
- Destruction of Pre-Malignant Skin Lesions
- Detection of Circulating Tumor Cells
- Diagnostic Infertility Surgery
- Diagnostic Nasal Endoscopy
- Donor Lymphocyte Infusion for Hematologic Malignancies after Allogeneic Hematopoietic Progenitor Cell Transplantation
- Drug Testing or Screening in the Context of Substance Use Disorder and Chronic Pain
- Durable Medical Equipment
- Electrical Stimulation as a Treatment for Pain and Other Conditions Surface and Percutaneous Devices
- Electroencephalography and Video Electroencephalographic Monitoring
- Electromyography and Nerve Conduction Studies
- Endometrial Ablation
- Esophageal pH Monitoring
- Extraosseous Subtalar Joint Implantation and Subtalar Arthroereisis
- Facet Joint Allograft Implants for Facet Disease
- Gamma Glutamyl Transferase Testing
- Gene Therapy for Beta Thalassemia
- Gene Therapy for Cerebral Adrenoleukodystrophy
- Gene Therapy for Duchenne Muscular Dystrophy
- Gene Therapy for Hemophilia
- Gene Therapy for Metachromatic Leukodystrophy
- Gene Therapy for Sickle Cell Disease
- Hand Transplantation
- Hematopoietic Stem Cell Transplantation for Hodgkin Disease and non-Hodgkin Lymphoma
- Hematopoietic Stem Cell Transplantation for Multiple Myeloma and Other Plasma Cell Dyscrasias
- Hematopoietic Stem Cell Transplantation for Select Leukemias and Myelodysplastic Syndrome
- Hepzato Kit (melphalan hepatic delivery system)
- High-volume Colonic Irrigation
- Home Enteral Nutrition
- Home Oxygen Therapy
- Home Phototherapy Devices for Neonatal Hyperbilirubinemia
- Hyperbaric Oxygen Therapy (Systemic Topical)
- Implantable Infusion Pumps
- Implantable Left Atrial Hemodynamic Monitor
- Implanted Artificial Iris Devices
- Implanted Devices for Spinal Stenosis
- In Vitro Chemosensitivity Assays and In Vitro Chemoresistance Assays
- Inhaled Nitric Oxide
- Intracytoplasmic Sperm Injection (ICSI)
- Intraoperative Neurophysiological Monitoring
- Intrapulmonary Percussive Ventilation Devices
- Irreversible Electroporation
- Ketogenic Diet for Treatment of Intractable Seizures
- Laser Trabeculoplasty and Laser Peripheral Iridotomy
- Lifting Devices for Use in the Home
- Lingual Frenotomy for Ankyloglossia-Related Feeding Difficulties
- Liver Transplantation
- Locoregional and Surgical Techniques for Treating Primary and Metastatic Liver Malignancies
- Lower Esophageal Sphincter Augmentation Devices for the Treatment of Gastroesophageal Reflux Disease (GERD)
- Lower Limb Prosthesis
- Low-Frequency Ultrasound Therapy for Wound Management
- Machine Learning Derived Probability Score for Rapid Kidney Function Decline
- Magnetic Source Imaging and Magnetoencephalography
- Manipulation Under Anesthesia
- Maze Procedure
- Mechanized Spinal Distraction Therapy
- Metagenomic Sequencing for Infectious Disease in the Outpatient Setting
- Microprocessor Controlled Knee-Ankle-Foot Orthosis
- Microprocessor Controlled Lower Limb Prosthesis
- Minimally Invasive Treatment of the Posterior Nasal Nerve to Treat Rhinitis
- Mobile Device-Based Health Management Applications
- Molecular Signature Test for Predicting Response to Tumor Necrosis Factor Inhibitor Therapy
- MRI Guided High Intensity Focused Ultrasound Ablation for Non-Oncologic Indications
- Multiplex Autoantigen Microarray Testing for Systemic Lupus Erythematosus
- Myocardial Strain Imaging
- Myocardial Sympathetic Innervation Imaging with or without Single-Photon Emission Computed Tomography (SPECT)
- Myoelectric Upper Extremity Prosthetic Devices
- Nasal Surgery for the Treatment of Obstructive Sleep Apnea and Snoring
- Nasal Valve Repair
- Near-Infrared Coronary Imaging and Near-Infrared Intravascular Ultrasound Coronary Imaging
- Neuromuscular Electrical Training for the Treatment of Obstructive Sleep Apnea or Snoring
- Non-invasive Heart Failure and Arrhythmia Management and Monitoring System
- Non-Obstetrical Transvaginal Ultrasonography
- Nucleic Acid Amplification Tests Using Algorithmic Analysis for the Diagnosis of Bacterial Vaginosis
- Occipital Nerve Block Therapy for the Treatment of Headache and Occipital Neuralgia
- Oral Pharyngeal and Maxillofacial Surgical Treatment for Obstructive Sleep Apnea or Snoring
- Outpatient Glycated Hemoglobin and Protein Testing
- Outpatient Laboratory-based Blood Glucose Testing
- Paraesophageal Hernia Repair
- Patent Foramen Ovale and Left Atrial Appendage Closure Devices for Stroke Prevention
- Penile Circumcision
- Per- and Polyfluoroalkyl Substances (PFAS) Testing
- PET MRI
- Portable Normothermic Organ Perfusion Systems
- Prefabricated and Prophylactic Knee Braces
- Preoperative Testing for Low Risk Invasive Procedures and Surgeries
- Pressure Reducing Support Surfaces – Groups 1 2 & 3
- Private Duty Nursing in the Home Setting
- Proprietary Algorithms for Liver Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease
- Prostate Saturation Biopsy
- Protein Biomarkers for the Screening Detection and Management of Prostate Cancer
- Quantitative Muscle Testing Devices
- Quantitative Sensory Testing
- Radioactive Seed Localization of Nonpalpable Breast Lesions
- Radiofrequency Ablation of the Renal Sympathetic Nerves
- Rehabilitative and Habilitative Services in the Home Setting Physical Medicine Physical Therapy Occupational Therapy and Speech-Language Pathology
- Remote Devices for Intermittent Monitoring of Intraocular Pressure
- Remote Therapeutic and Physiologic Monitoring Services
- Resting Electrocardiogram Screening in Adults
- Review of Services for Benefit Determinations in the Absence of a Company Applicable Medical Policy or Clinical Utilization Management (UM) Guideline
- Robotic Arm Assistive Devices
- Rupture of Membranes Testing in Pregnancy
- Screening for Vitamin D Deficiency in Average Risk Individuals
- Seat Lift Mechanisms
- Selected Protein Biomarker Algorithmic Assays
- Self-Operated Spinal Unloading Devices
- Serum Biomarker Tests for Multiple Sclerosis
- Serum Biomarker Tests for Risk of Preeclampsia
- Site of Care Specialty Pharmaceuticals
- Skilled Nursing and Skilled Rehabilitation Services (Outpatient)
- Spinal Orthoses Thoracic-Lumbar-Sacral (TLSO) Lumbar-Sacral (LSO) and Lumbar
- Surface Electromyography and Electrodermal Activity Sensor Devices for Seizure Monitoring
- Surgical and Ablative Treatments for Chronic Headaches
- Systems Pathology Testing for Prostate Cancer
- Testing for Biochemical Markers for Alzheimers Disease
- Therapeutic Apheresis
- Therapeutic use of Stem Cells Blood and Bone Marrow Products
- Three-Dimensional (3-D) Rendering of Imaging Studies
- Thymus Tissue Transplantation
- Thyroid Testing
- Tonsillectomy with or without Adenoidectomy for Adults
- Transanal Irrigation
- Transcatheter Ablation of Arrhythmogenic Foci in the Pulmonary Veins
- Transcatheter Heart Valve Procedures
- Transcatheter Uterine Artery Embolization
- Transendoscopic Therapy for Gastroesophageal Reflux Disease Dysphagia and Gastroparesis
- Transrectal Ultrasonography
- Ultrasonic Diathermy Devices
- Ultraviolet Light Therapy Delivery Devices for Home Use
- Upper Gastrointestinal Endoscopy in Adults
- Uterine Fibroid Ablation Laparoscopic Percutaneous or Transcervical Image Guided Techniques
- Uterine Transplantation
- Vacuum Assisted Wound Therapy in the Outpatient Setting
- Wearable Cardioverter Defibrillators
- Zika Virus Testing
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