BCBS Arkansas Medical Policy Updates – December 2022

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

December 2022 BCBS Arkansas Medical Policy Updates:

• Ablation Therapy, Radiofrequency and Cryoablation of Pulmonary Tumors
• Acupuncture
• Alglucosidase alfa (Lumizyme™)
• Allergen Specific IgE In Vitro Testing
• Amniotic Membrane and Amniotic Fluid Injections
• Artificial Heart, Total
• Autism Spectrum Disorder, Early Behavioral Intervention
• Automated Whole Breast Ultrasound
• Avalglucosidase alfa-ngpt (Nexviazyme)
• Axillary Reverse Mapping for Prevention of Breast Cancer-Related Lymphedema
• Belimumab (Benlysta)
• Biomarker Test, PreDx, Diabetes Risk Score
• Biomarker Testing (Including Liquid Biopsy) for Targeted Treatment and Immunotherapy in Breast Cancer
• Blepharoplasty/Blepharoptosis
• Bone Morphogenetic Protein
• Brachytherapy, Brain Tumors
• Brachytherapy, Breast
• Brachytherapy, Prostate, High-Dose Rate Temporary
• Bronchial Thermoplasty
• Chemodenervation, Botulinum Toxins
• Chemotherapy for Malignancy
• Computed Tomography, Cardiac and Coronary Artery
• Continuous Passive Motion Device In the Home Setting
• Coverage Policy Manual – Arkansas Blue Cross and Blue Shield
• Covid-19 Monoclonal Antibody Therapy
• Digital Health Technologies: Diagnostic Applications
• Dry Hydrotherapy for Chronic Pain Conditions
• Dupilumab
• Eptinezumab-jjmr (e.g., VYEPTI™)
• Etelcalcetide
• Gene Therapies for Thalassemia: Betibeglogene autotemcel (e.g., Zynteglo)
• Genetic Test: Alpha Thalessemia
• Genetic Test: Biomarker Testing (Including Liquid Biopsy) for Targeted Treatment and Immunotherapy in Ovarian Cancer
• Genetic Test: Biomarker Testing (Including Liquid Biopsy) for Targeted Treatment and Immunotherapy in Prostate Cancer
• Genetic Test: BRCA1 or BRCA2 Mutations
• Genetic Test: Breast Ca; Risk Recurrence to Determine Need for Adjuvant Therapy (Oncotype DX)
• Genetic Test: Cancer Susceptibility Panels Using Next Generation Sequencing
• Genetic Test: Chromosomal Microarray Analysis (CMA) and Next-Generation Sequencing (NGS) Panels for the Genetic Evaluation of Patients with Developmental Delay/Intellectual Disability or Autism Spectrum Disorder
• Genetic Test: Fecal DNA to Detect Colorectal Cancer, Screening
• Genetic Test: Genetic and Protein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer
• Genetic Test: Hereditary Diffuse Gastric Cancer (CDH1, CTNNA1)
• Genetic Test: Hereditary Pancreatitis
• Genetic Test: KIT (c-KIT, CD117)
• Genetic Test: Laboratory and Genetic Testing for Use of 5-Fluorouracil in Patients with Cancer
• Genetic Test: Pharmacogenetic Testing for Pain Management
• Genetic Test: Statin-Induced Myopathy (SLCO1B1)
• Glucose Monitoring, Continuous
• Guselkumab
• HDC & Autologous Stem &/or Progenitor Cell Support-Hodgkin’s Disease
• Immune Cell Function Assay
• Injection, Clostridial Collagenase for Fibroproliferative Disorders
• Meniscal Allograft Transplantation and Synthetic Meniscal Implants
• Mepolizumab (Nucala)
• Metabolite Testing, Monitor Antimetabolite Therapy for Inflammatory Bowel & Collagen Vascular Disease, Acute Lymphoblastic Leukemia
• Metreleptin
• Ocrelizumab (Ocrevus)
• Oscillatory Devices for Chest Physical Therapy
• Pasireotide (Signifor or Signifor LAR)
• Pegcetacoplan (e.g., Empaveli)
• Pertuzumab
• PET or PET/CT for Bone Cancer
• PET or PET/CT for Cancer Surveillance and Other Oncologic Applications
• PET or PET/CT for Head and Neck Malignant Disease
• PET or PET/CT for Hodgkin’s Lymphoma
• PET or PET/CT for Malignant Brain Tumors
• PET or PET/CT for non-Hodgkin’s Lymphoma
• PET or PET/CT for Penile Cancer
• PET or PET/CT for Soft Tissue Sarcoma, including Gastrointestinal Stromal Tumor (GIST)
• PET Scans (Positron Emission Tomography)
• PET Scans (Positron Emission Tomography)
• PET Scans (Positron Emission Tomography)
• Pilot Policy: Telemedicine for Applied Behavioral Analysis in the Treatment of Autism Spectrum Disorder
• Plugs for Anal Fistula Repair
• Preimplantation Genetic Diagnosis, Testing or Treatment
• Preventive Services for Non-Grandfathered (PPACA) Plans: BRCA Testing; Genetic Counseling and Evaluation
• Preventive Services for Non-Grandfathered (PPACA) Plans: Overview
• Preventive Services for Non-Grandfathered (PPACA) Plans: RH Incompatability Screening
• PREVENTIVE SERVICES FOR NON-GRANDFATHERED (PPACA) PLANS: SYPHILIS SCREENING
• Preventive Services for Non-Grandfathered (PPACA) Plans: Type 2 Diabetes Mellitus Screening for Adults
• Procalcitonin
• Prostate Cancer Predicting Risk of Recurrence, Systems Pathology
• Proteomics, Screening and Detection of Cancer (e.g., OvaCheck)
• Risankizumab (e.g., Skyrizi)
• Sacroiliac Joint Fusion, Minimally Invasive
• Serum Antibodies for Diagnosis of Inflammatory Bowel Disease
• Site of Care or Site of Service Review
• Skin and Soft Tissue Substitutes, Bio-Engineered Products
• Sleep Apnea, Minimally Invasive Surgical Treatment
• ST2 Assay for Chronic Heart Failure
• Stem Cell Growth Factors, Erythropoiesis-Stimulating Agents (ESAs), Darbepoetin, Epoetin, Peginesatide
• Subconjunctival Retinal Prosthesis
• Surgery for Morbid Obesity
• Tildrakizumab-asmn (e.g., Ilumya)
• Transanal Endoscopic Microsurgery (TEMS/TAMIS)
• Transcatheter Mitral Valve Repair
• Transplant, Heart/Lung
• Trilaciclib (Cosela)
• Under Heavy Sedation or General Anesthesia as a Technique of Opioid Detoxification
• Vestibular Function Testing

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

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