BCBS Arkansas Medical Policy Updates – July 2022

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

July 2022 BCBS Arkansas Medical Policy Updates:

• Autologous Stem-cell Therapy to Treat Peripheral Arterial Disease
• Biventricular Pacemakers for the Treatment of Congestive Heart Failure
• Bortezomib (e.g., Velcade)
• Brachytherapy, Prostate, Low-dose Rate
• Cardioverter Defibrillator; Implantable, Subcutaneous, and Wearable Cardioverter Defibrillator
• Chelation Therapy
• Computed Tomography (CT) Scanning for Lung Cancer Screening
• Cryosurgical Ablation of Breast Tumors, Benign and Malignant
• Cryosurgical Ablation of Pancreatic Cancer
• Cryosurgical Ablation of Renal Tumors
• Current Perception Threshold Test
• Digital Health Therapies for Substance Abuse
• Dry Needling of Myofascial Trigger Points
• Eculizumab (Soliris)
• Electrical Stimulation, Advanced Transcutaneous Electrical Stimulation
• Electrical Stimulation, Auricular Stimulation and Cranial Electrotherapy Stimulation
• Electrical Stimulation, Percutaneous Electrical Nerve Stimulation (PENS) or Percutaneous Neuromodulation Therapy (PNT)
• Endovascular Stent Grafts for Thoracic Aortic Aneurysms or Dissections
• External Enhanced Cardiac Counterpulsation (EECP)
• Gait Analysis
• Genetic Test: Cytochrome p450 Genotyping
• Genetic Test: Hemochromatosis
• Genetic Test: Melanoma, V600 Mutation Testing to Predict Response to BRAF Inhibitor Targeted Therapy
• Genetic Test: Proteogenomic Testing for Patients with Cancer (GPS Cancer Test)
• Genetic Test: Testing for the Diagnosis and Management of Mental Health Conditions
• High Dose Chemotheraphy with Allogenic or Autologous Stem Cell and/or Progenitor Cell Support
• Hyperhidrosis Treatment
• Implantable Bone Conduction Hearing Aids
• Inebilizumab-cdon (e.g., Uplizna™)
• Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)
• Leadless Cardiac Pacemakers
• Left Atrial Appendage, Closure Device, Percutaneous
• Lung Volume Reduction Surgery (LVRS)
• Magnetic Resonance Imaging (MRI), Functional
• Mammoplasty, Reduction
• Mastectomy, Prophylactic
• MR Guided Ultrasound Ablation – Uterine Fibroids and Other Tumors
• Multitarget Polymerase Chain Reaction Testing for Diagnosis of Bacterial Vaginosis (SureSwab) (NuSwab)
• 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)
• Panitumumab (Vectibix™)
• Pemetrexed (Alimta)
• PET Scan for Alzheimer’s Disease Using Beta Amyloid Imaging
• Pharmacy: Lutetium Lu 177 Dotatate (Lutathera®)
• Phosphodiesterase-5 (PDE-5) Inhibitors for Benign Prostatic Hypertrophy (Tadalafil)
• Phototherapy for Vitiligo
• Polysomnography for Non-Respiratory Sleep Disorders
• PPACA: Prevention Of Human Immunodeficiency Virus (HIV) Infection, Preexposure Prophylaxis
• Preventive Services For Non-Grandfathered (Ppaca) Plans: Aspirin To Prevent Cardiovascular Disease In Adults
• Radiofrequency Ablation, Barrett’s Esophagus
• Radiofrequency Ablation, Renal Tumors
• Radioimmunotherapy in the Treatment of Non-Hodgkin Lymphoma
• Radium Ra 223 Dichloride for Symptomatic Osseous Metastatic Prostate Cancer (Xofigo®; Ra 223)
• Remote Electrical Neuromodulation for Migraines
• Risankizumab (e.g., Skyrizi)
• Rituximab (e.g., Rituxan) and Biosimilars – Non-Oncologic Indications
• Sacituzumab govitecan-hziy (e.g., Trodelvy™)
• Short Tandem Repeat Analysis for Specimen Provenance Testing (know error® system)
• Sleep Apnea and Other Pulmonary Diseases, Ventilation Support and Respiratory Assist Devices
• Sleep Apnea, Testing
• Temporomandibular Joint Dysfunction
• Thermography and Infrared Dermal Thermometry
• Tumor-Treating Fields Therapy for Glioblastoma (NovoTTF)
• Vertical Expandable Prosthetic Titanium Rib

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

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