BCBS Arkansas Medical Policy Updates – July 2018

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

July 2018  Medical Policy Updates:

• Allergy Testing, Serial Endpoint Testing
• Antiprothrombin Antibody
• Aqueous Shunts and Devices for Glaucoma
• Autologous Stem-cell Therapy to Treat Peripheral Arterial Disease
• Biomarker Panel Testing for Systemic Lupus Erythematosus
• Brachytherapy, Radioembolization of Primary & Metastatic Tumors of the Liver with Therapeutic Microspheres
• Cardioverter Defibrillator; Implantable, Subcutaneous, and Wearable Cardioverter Defibrillator
• Chelation Therapy
• Chemotherapy for Malignancy
• Computed Tomography (CT) Scanning for Lung Cancer Screening
• Corneal Topography
• Cryosurgical Ablation of Breast Tumors, Benign and Malignant
• Cryosurgical Ablation of Pancreatic Cancer
• Cryosurgical Ablation of Renal Tumors
• Dry Needling of Myofascial Trigger Points
• Electrical Stimulation, Auricular Stimulation and Cranial Electrotherapy Stimulation
• Endovascular Stent Grafts for Thoracic Aortic Aneurysms or Dissections
• External Enhanced Cardiac Counterpulsation (EECP)
• Femoroacetabular Impingement, Surgical Treatment of
• Gait Analysis
• Genetic Test: Acute Myeloid Leukemia, (FLT3 and NPM1)
• Genetic Test: Adolescent Idiopathic Scoliosis; Prediction of Disease Progression
• Genetic Test: Amyotrophic Lateral Sclerosis
• Genetic Test: Aspirin Treatment, Lipoprotein(a) Variant(s) as a Decision Aid
• Genetic Test: Breast Ca; Risk Recurrence to Determine Need for Adjuvant Therapy (Oncotype DX)
• Genetic Test: Breast Ca; Risk Recurrence to Determine Need for Adjuvant Therapy (Oncotype DX)
• Genetic Test: Celiac Disease, HLA Typing (HLA-DQ)
• Genetic Test: CHARGE Syndrome
• Genetic Test: Coronary Artery Disease, Testing to Predict Risk (Corus CAD™)
• Genetic Test: Cytochrome p450 Genotyping
• Genetic Test: FMR 1 Mutations Including Fragile X Syndrome
• Genetic Test: FMR 1 Mutations Including Fragile X Syndrome
• Genetic Test: Li-Fraumeni Syndrome
• Genetic Test: Lynch Syndrome and Inherited Intestinal Polyposis Syndromes
• Genetic Test: Melanoma, V600 Mutation Testing to Predict Response to BRAF Inhibitor Targeted Therapy
• Genetic Test: Melanoma, V600 Mutation Testing to Predict Response to BRAF Inhibitor Targeted Therapy
• Genetic Test: Microarray-based Gene Expression Profile Analysis for Prostate Cancer Management
• Genetic Test: Molecular Markers in Fine Needle Aspirates of the Thyroid
• Genetic Test: Testing for the Diagnosis and Management of Mental Health Conditions
• Genetic Test: Whole Exome Sequencing
• HDC & Autologous Stem &/or Progenitor Cell Support-Non Hodgkin’s Lymphomas
• Hereditary Angioedema (HAE), Prophylaxis and Acute Treatment
• High Dose Chemotheraphy with Allogenic or Autologous Stem Cell and/or Progenitor Cell Support
• High Dose Chemotheraphy with Allogenic or Autologous Stem Cell and/or Progenitor Cell Support
• High Dose Chemotheraphy with Allogenic or Autologous Stem Cell and/or Progenitor Cell Support
• High Dose Chemotheraphy with Allogenic or Autologous Stem Cell and/or Progenitor Cell Support
• Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)
• Intradialytic Parenteral Nutrition
• Irreversible Electroporation, Nanoknife
• Laser Treatment of Onychomycosis
• Magnetic Resonance Imaging (MRI), Functional
• Mammoplasty, Reduction
• Microprocessor-Controlled Prostheses for the Lower Limb
• Molecular Testing in the Management of Pulmonary Nodules
• Myocardial Damage, Autologous Cell Therapy(progenitor, hematopoietic stem cells, myoblasts)
• Myocardial Sympathetic Innervation Imaging in Patients with Heart Failure
• Neurofeedback
• Novel Lipid Risk Factors in Risk Assessment and Management of Cardiovascular Disease (apolipoprotein B) (apolipoprotein A-1) (HDL subclass) (LDL subclass) (apolipoprotein E) (Lipoprotein A)
• Oophorectomy, Prophylactic
• Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome
• Pemetrexed (Alimta)
• Pharmacy: Lutetium Lu 177 Dotatate (Lutathera®)
• Phototherapy for Vitiligo
• Positron Emission Mammography (PEM)
• Preventive Services For Non-Grandfathered (Ppaca) Plans: Aspirin To Prevent Cardiovascular Disease In Adults
• Radiofrequency Ablation of Peripheral Nerves to Treat Pain Associated with Plantar Fasciitis or Knee Osteoarthritis
• Radiofrequency Ablation, Barrett’s Esophagus
• Radiofrequency Ablation, Renal Tumors
• Sacral Nerve Stimulation for the Treatment of Fecal Incontinence
• Sacral Nerve Stimulation for the Treatment of Urge Urinary Incontinence
• Sleep Apnea and Other Pulmonary Diseases, Ventilation Support and Respiratory Assist Devices
• Sleep Apnea, Testing
• Soft Tissue Substitutes, Orthobiologic Implant
• Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy Gamma Knife Surgery, Linear Accelerator, Cyberknife, TomoTherapy
• Subconjunctival Retinal Prosthesis
• Thermography and Infrared Dermal Thermometry
• Transplant, Autologous Islet Cell for Chronic Pancreatitis
• Transplant, Lung and Lobar Lung
• Triamcinolone Acetonide Extended Release (Zilretta)
• Tumor-Treating Fields Therapy for Glioblastoma (NovoTTF)
• Uterine Artery Embolization for the Treatment of Leiomyomas or Abnormal Uterine Bleeding
• Vertical Expandable Prosthetic Titanium Rib
• Virtual Colonoscopy/CT Colonography
• Whole Gland Cryosurgical Ablation of Prostate Cancer

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

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