BCBS Arkansas Medical Policy Updates – March 2019

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

March 2019 BCBS Arkansas Medical Policy Updates:

• Amniotic Membrane and Amniotic Fluid Injections
• Artificial Vertebral Disc, Lumbar Spine
• Circulating Tumor Cells in the Management of Patients with Cancer, Detection of
• Cold Therapy
• Confocal Laser Endomicroscopy
• Endobronchial Valves
• Endovascular Procedures for Intracranial Arterial Disease and Extracranial Vertebral Artery Disease
• Epiretinal Radiation Therapy for Age-Related Macular Degeneration
• Extracorporeal Membrane Oxygenation for Adult Conditions
• Extracorporeal Shock Wave Therapy for Plantar Fasciitis and Other Musculoskeletal Conditions
• Genetic Test: Chromosomal Microarray Testing for the Evaluation of Pregnancy Loss
• Genetic Test: Duchenne and Becker Muscular Dystrophy
• Genetic Test: HERmark, HER2 Breast Cancer Assay for Measurement of HER2 Total Protein Expression and HER2 Dimers
• Genetic Test: Multiple Myeloma, Gene Expression Profiling
• HDC & Allogeneic Stem &/or Progenitor Cell Support-Hodgkin’s Disease
• HDC & Autologous Stem &/or Progenitor Cell Support-Acute Lymphocytic Leukemia
• HDC & Progenitor Cell Support AL Amyloidosis (Light Chain Amyloidosis)
• 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
• HIV Tropism, Testing
• Human Papilloma Virus Testing of Cervical Pap Smears
• Implantable Infusion Pump
• Ingestible pH and Pressure Capsule
• Intraepidermal Nerve Fiber Density
• Keratoprosthesis
• Multitarget Polymerase Chain Reaction Testing for Diagnosis of Bacterial Vaginosis (SureSwab) (NuSwab)
• Ocrelizumab (Ocrevus)
• Optical Coherence Tomography Anterior Eye Segment Imaging
• Optical Diagnostic Devices for Evaluating Skin Lesions Suspected of Malignancy
• Peripheral Subcutaneous Field Stimulation
• PET or PET/CT for Bone Cancer
• PET or PET/CT for Brain Imaging, Non-malignant Disease
• PET or PET/CT for Esophageal or Esophagogastric Junction (EGJ) Cancer
• PET or PET/CT for Malignant Brain Tumors
• PET or PET/CT for Penile Cancer
• Pet or Pet/CT for Vulvar Carcinoma
• PET Scans (Positron Emission Tomography)
• PET Scans (Positron Emission Tomography)
• PET Scans (Positron Emission Tomography)
• PET Scans (Positron Emission Tomography)
• PET Scans (Positron Emission Tomography)
• PET Scans (Positron Emission Tomography)
• PET Scans (Positron Emission Tomography)
• Positional Magnetic Resonance Imaging
• Radiofrequency Treatment, Chronic Back Pain (Nucleoplasty)
• Rituximab (Rituxan), Off-label Use
• Semi-Implantable and Fully Implantable Middle Ear Hearing Aid for Moderate to Severe Sensorineural Hearing Loss
• Transcatheter Aortic Valve Implantation

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

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