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BCBS Arkansas Medical Policy Updates – December 2024
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Click here to view the Blue Cross Blue Shield BCBS Arkansas Medical Policy Updates »
December 2024 BCBS Arkansas Medical Policy Updates:
- Adoptive Immunotherapy
- Alglucosidase alfa (Lumizyme™)
- Apheresis, Therapeutic (Plasma Exchange Transfusion)
- Avalglucosidase alfa-ngpt (Nexviazyme)
- Bevacizumab (e.g., Avastin) and Biosimilars for Ophthalmic Use
- Biofeedback for Miscellaneous Indications
- Cardiac Event Recorder, External Loop or Continuous Recorder
- Certolizumab pegol (e.g., Cimzia)
- Chemodenervation, Botulinum Toxins
- Chemotherapy for Malignancy
- Ciltacabtagene Autoleucel (e.g., Carvykti)
- Cipaglucosidase alfa-atga (e.g., Pombiliti)
- Coverage Policy Manual – Arkansas Blue Cross and Blue Shield
- Coverage Policy Manual – Arkansas Blue Cross and Blue Shield
- Coverage Policy Manual – Arkansas Blue Cross and Blue Shield
- Coverage Policy Manual – Arkansas Blue Cross and Blue Shield
- Eptinezumab-jjmr (e.g., VYEPTI™)
- Etelcalcetide
- Exagamglogene autotemcel (e.g., Casgevy)
- Factor IX (e.g., AlphaNine, Alprolix, BeneFIX, Idelvion, Ixinity, Mononine, Profilnine, Rebinyn, Rixubis)
- Factor VIII (e.g., Advate, Adynovate, Afstyla, Alphanate, Altuviiio, Eloctate, Esperoct, Jivi, Hemofil-M, Humate-P, Koate, Kogenate, Kovaltry, Novoeight, Nuwiq, Obizur, Recombinate, Wilate, Xyntha)
- Fidanacogene elaparvovec-dzkt (e.g., Beqvez)
- Genetic Test: Germline Mutations of the RET Protooncogene in Medullary Carcinoma of the Thyroid
- Hormone Pellet Implantation for Hormone Replacement Therapy
- Idecabtagene Vicleucel (e.g., Abecma)
- Immune Globulin- Hematologic, Transplant, Infectious Disease and Miscellaneous Indications
- Immune Globulin, Autoimmune, Rheumatic and Neurologic indications
- Immune Globulin, Intravenous and Subcutaneous
- Lisocabtagene Maraleucel (e.g., Breyanzi)
- Magnetic Resonance Imaging (MRI), Cardiac Applications
- Metreleptin
- Mogamulizumab- kpkc (e.g., Poteligeo)
- Mutation Molecular Analysis for Targeted Therapy in Patients With Non-Small-Cell Lung Cancer
- Naxitamab-gqgk (e.g., Danyelza)
- Nogapendekin alfa inbakicept-pmln (e.g., Anktiva)
- Ocrelizumab (Ocrevus)
- Onasemnogene Abeparvovec-XIOI (Zolgensma®)
- Pasireotide (Signifor or Signifor LAR)
- Patient-actuated End Range Motion Stretching Devices
- Pemetrexed (Alimta)
- Pertuzumab
- PET or PET/CT for Cancer Surveillance and Other Oncologic Applications
- PET or PET/CT for Head and Neck Malignant Disease
- PET Scan for Multiple Myeloma, Plasmacytoma
- PET Scans (Positron Emission Tomography)
- PET Scans (Positron Emission Tomography)
- Pulmonary Arterial Hypertension, Pharmacological Treatment with Prostacyclin Analogues, Endothelin Receptors Antagonists, or Phosphodiesterase Inhibitors
- Pulmonary Rehabilitation
- Sacroiliac Joint Fusion, Minimally Invasive
- Self-Administered Medication
- Site of Care or Site of Service Review
- Stem Cell Growth Factor, Romiplostim (Nplate)
- Tarlatamab-dlle (e.g., Imdelltra)
- Testing for Alpha-1 Antitrypsin Deficiency
- Thyroid Disease Testing
- Tildrakizumab-asmn (e.g., Ilumya)
- Trastuzumab AND Trastuzumab and Hyaluronidase-oysk
- Trilaciclib (Cosela)
- Triptorelin (e.g., Triptodur, Trelstar)
- Urine Culture Testing for Bacteria
- Ustekinumab (Stelara)
- Vascular Epithelial Growth Factors for Ophthalmic use (e.g., Beovu, Byooviz, Cimerli, Eylea, Eylea HD, Lucentis, Vabysmo)
- Venous and Arterial Thrombosis Risk Testing
- Virtual Colonoscopy/CT Colonography
- Vitamin B12 and Methylmalonic Acid Testing
- White Blood Cell Growth Factors (Colony Stimulating Factors)
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