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BCBS Arizona Medical Policy Updates – October 2018
Click here to view the Arizona Blue Cross Blue Shield Medical Policy Updates »
October 2018 Medical Policy Updates:
- Autologous Adipose-Derived Regenerative Cell Therapy for Scleroderma
- Biologic and Immunological Agents
- Boniva
- Closure Devices for Atrial and Ventricular Septal Defects and Patent Foramen Ovale
- Composite Tissue Allotransplantation
- Diagnosis and Medical Management of Obstructive Sleep Apnea Syndrome
- Entyvio
- Genetic Testing for Developmental Delay, Intellectual Disability, Autism Spectrum Disorder and Congenital Anomalies
- Genetic Testing for Moderate Penetrance Variants Associated With Breast Cancer in Individuals at High Breast Cancer Risk
- Genetic Testing With Invasive Prenatal (Fetal) Diagnostic Testing
- Heart Transplant
- Heart/Lung Transplant
- Hydrogel Spacer for use in Radiotherapy Treatment of Prostate Cancer
- Hydroxyprogesterone Therapy
- Hydroxyprogesterone Therapy
- Ilaris
- Inflectra and Renflexis
- Kineret
- Laparoscopic and Percutaneous Techniques for the Myolysis of Uterine Fibroids
- Liver Transplant and Combined Liver-Kidney Transplant
- Lung Transplant
- Magnetic Resonance Imaging (MRI) Targeted Biopsy of the Prostate
- MRI of the Breast
- Multigene Expression Assay for Predicting Recurrence in Colon Cancer
- Multiple Sclerosis Injectable Therapy
- Near Infrared Spectroscopic Examination of Wounds
- Newborn Screening Tests
- Noninvasive Prenatal Testing for Fetal Aneuploidies and Microdeletions Using Cell Free Fetal DNA
- Occlusion of Uterine Arteries Using Transcatheter Embolization
- Pancreas Transplants
- Pancreatic Islet Transplant
- Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence
- Percutaneous Balloon Kyphoplasty, Radiofrequency Kyphoplasty and Mechanical Vertebral Augmentation
- Power Morcellation of the Uterus and Prostate
- Preimplantation Genetic Diagnosis
- Prolia
- Prostatic Urethral Lift
- Reclast
- Respiratory Syncytial Virus (RSV) Prophylactic Treatment
- Rituxan, Nononcologic Uses
- Serum Antibody Detection for Merkel Cell Carcinoma
- Site of Service Requirements for Certain Medications
- Small Bowel Transplant
- Small Bowel/Liver and Multivisceral Transplant
- Therapeutic Taping
- Urinary Disorder Treatments
- Urine Drug Testing for Drug-Drug Interaction and Urine Specimen DNA Authentication Testing
- Whole Gland Cryoablation of Prostate Cancer
- XGEVA
- Yescarta™ (axicabtagene ciloleucel)
Added 10/31/2018;
- Ablative Fractional Carbon Dioxide Laser Fenestration of Burn and Traumatic Scars
- Abortion
- Ambulance Services
- Apokyn
- Bavencio
- Benlysta
- Beta Amyloid Imaging With Positron Emission Tomography (PET) for Alzheimer’s Disease
- Biologic and Immunological Agents
- Computed Tomography (CT) Perfusion Imaging
- Computed Tomography (CT) to Detect Coronary Artery Calcification
- DEXA Scan for Vertebral Fracture Screening
- Diagnosis and Medical Management of Obstructive Sleep Apnea Syndrome
- Durable Medical Equipment (DME)
- Electrostimulation and Electromagnetic Therapy for the Treatment of Wounds
- Endobronchial Ulatrasound for Diagnosis and Staging of Lung Cancer
- Erythropoiesis-Stimulation Agents (ESAs)
- Focal Treatments for Prostate Cancer
- Foot Disorder Treatments
- Functional MRI of the Brain
- Genetic Testing for Lynch Syndrome and Other Inherited Colon Cancer Syndromes
- Genital Reconstruction, Enhancement and Rejuvenation Procedures
- Growth Hormone Therapy Chart
- Hematopoietic Cell Transplantation
- Hematopoietic Cell Transplantation for Non-Hodgkin Lymphomas
- Hereditary Angioedema Medication Therapy
- Hydroxyprogesterone Therapy
- Immunizations
- Implantable Counterpulsation Ventricular Assistance System
- Injectafer
- Inpatient Subacute Behavioral Health Treatment/Residential Treatment Facility Services
- Magnetic Resonance (MR) Spectroscopy
- Magnetocephalography and Magnetic Source Imaging
- Microwave Tumor Ablation
- MRI for Evaluating Breast Implant Integrity
- Myocardial Sympathetic Innervation Imaging in Individuals With Heart Failure
- Neuroablation and Other Procedures for Treatment of Chronic Pain
- Novel Biomarkers in Risk Assessment and Management of Cardiovascular Disease
- Optical Coherence Tomography (OCT) for Imaging of Coronary Arteries
- Optical Coherence Tomography (OCT) of the Middle Ear
- Parsabiv
- Percutaneous Balloon Kyphoplasty, Radiofrequency Kyphoplasty and Mechanical Vertebral Augmentation
- Positron Emission Mammography (PEM)
- Prolia
- Radicava
- Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors
- Radiofrequency Ablation of Peripheral Nerves to Treat Pain
- Radiofrequency Ablation of the Renal Sympathetic Nerves as Treatment for Hypertension
- Radioimmunoscintigraphy Imaging for Prostate Cancer
- Scintimammography and Gamma Imaging of the Breast and Axilla
- Screening Mammography in Males
- Sexually Transmitted Disease Testing
- Thermography
- Tilt Table Testing for the Evaluation of Syncope
- Varicocele Treatments
- Ventricular Assist Devices and Total Artificial Hearts
- Virtual Colonoscopy/CT Colonography
Click here to view the Arizona Blue Cross Blue Shield Medical Policy Updates »
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