BCBS Arkansas Medical Policy Updates – August 2018

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

August 2018 BCBS Arkansas Medical Policy Updates:

• Ablation Therapy for Atrial Fibrillation (Pulmonary Venous Isolation, Radiofrequency, Cryoablation, AV Node Ablation)
• Acupuncture
• Annuloplasty, Percutaneous Intradiscal: Electrothermal (IDET), Radiofrequency (PIRFT) or Biacuplasty
• Anti-PD-1 (programmed death receptor-1)Therapy (Pembrolizumab)(Nivolumab)
• Atezolizumab (Tecentriq)
• Biofeedback as a Treatment of Urinary Incontinence in Adults
• Biofeedback for Miscellaneous Indications
• Carotid Intima -Media Thickness, Ultrasound Measurement to Assess Subclinical Atherosclerosis
• Chemical Peels
• Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure
• Cord Blood as a Source of Stem Cells for Potential Disease
• Cord Blood as a Source of Stem Cells for Treatment of Identified (Diagnosed) Disease
• Corneal Collagen Cross-linking
• Edaravone
• Genetic Test: Proteogenomic Testing for Patients with Cancer (GPS Cancer Test)
• Posturography, Dynamic/Static
• Nutritional Panel Testing (NutrEval®, ONE FMV™)
• Lymphedema Pumps (Pneumatic Compression Devices) for the Treatment of Lymphedema and Venous Ulcers
• Photochemotherapy, Extracorporeal (Photopheresis) as a Treatment to Prevent Rejection Following Solid-Organ Transpla
• Magnetic Resonance Spectroscopy
• Cytoreduction Surgery with Hyperthermic Intraperitoneal Chemotherapy
• Digital Breast Tomosynthesis
• Electrical Stimulation, Transcutaneous Electrical Nerve Stimulator
• Electrical Stimulation, Vagus Nerve Stimulation for the Treatment of Depression
• Electrical Stimulation, Vagus Nerve Stimulation for the Treatment of Essential Tremors
• Electrical Stimulation, Vagus Nerve Stimulation for the Treatment of Fibromyalgia
• Electrical Stimulation, Vagus Nerve Stimulation for the Treatment of Headaches
• Electrical Stimulation, Vagus Nerve Stimulation for the Treatment of Heart Failure
• Electrical Stimulation, Vagus Nerve Stimulation for the Treatment of Obesity
• Electrical Stimulation, Vagus Nerve Stimulation for the Treatment of Seizures
• Food and Chemical Sensitivity Testing
• Genetic Test: Facioscapulohumeral Muscular Dystrophy
• Genetic Test: Factor V Leid
• Genetic Test: Germline Mutations of the RET Protooncogene in Medullary Carcinoma of the Thyroid
• Genetic Test: Inherited Thrombophilia, Prothrombin Gene Mutations (G20210A) and MTHFR Mutations
• Genetic Test: Mitochondrial Disorders
• Genetic Test: Mutation Testing for Limb-Girdle Muscular Dystrophies
• Glucose Monitoring, Continuous
• Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins during Breast-Conserving Surgery
• Interventions for Progressive Scoliosis
• Measurement of Serum Intermediate Density Lipoproteins (Remnant-like Particles)
• Multiple Sleep Latency/Maintenance of Wakefulness Test
• Myoelectric Prosthesis for the Upper Limb
• Neuromuscular Stimulation, Functional
• Orthopedic Applications of Stem Cell Therapy
• Osteochondral Autograft Transfer (OATS) and/or Mosaicplasty For Osteochondral Defects of the Knee
• Paliperidone Palmitate (Long-acting Injectables Invega Sustenna ® & Invega Trinza)
• Photochemotherapy, Extracorporeal (Photopheresis) as a Treatment of Cutaneous T-Cell Lymphoma
• Photochemotherapy, Extracorporeal (Photopheresis) as a Treatment of Graft-versus-Host Disease
• Preventive Services for Non-Gradfathered (PPACA) Plans: Lung Cancer Screening
• Preventive Services for Non-Grandfathered (PPACA) Plans: Dental Caries Prevention in Preschool Children
• Preventive Services For Non-Grandfathered (Ppaca) Plans: Depression Screening, Adults
• Preventive Services for Non-Grandfathered (PPACA) Plans: Hearing Loss Screening in Newborns UP to Age 21
• Preventive Services for Non-Grandfathered (PPACA) Plans: Hepatitis C Virus Screening
• Preventive Services for Non-Grandfathered (PPACA) Plans: Human Papillomavirus (HPV), Screening for Sexually Active Women
• Preventive Services for Non-Grandfathered (PPACA) Plans: Lead Screening in Infants and Children Through Age Six
• Preventive Services for Non-Grandfathered (PPACA) Plans: Sickle Cell Disease, Newborn Screening
• Preventive Services for Non-Grandfathered (PPACA) Plans: Tobacco use, Screening, Counseling and Interventions
• Prolotherapy (Sclerotherapy)
• Radiofrequency Ablation of Primary or Metastatic Liver Tumors
• Radiofrequency Treatment, Chronic Back Pain (Nucleoplasty)
• Repair of Durable Medical Equipment (DME) and External Prosthetic Devices
• Repository Corticotropin Injection
• Sphenopalatine Ganglion Block for Headache
• ST2 Assay for Chronic Heart Failure
• Subconjunctival Retinal Prosthesis
• Surgical Deactivation of Headache Trigger Sites
• Total Facet Arthroplasty
• Transplant, Liver
• Treatment of Varicose Veins/Venous Insufficiency
• Ultrasound Accelerated Fracture Healing Device

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

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