BCBS Arkansas Medical Policy Updates – May 2021

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

May 2021 BCBS Arkansas Medical Policy Updates:

• Alcohol Injections for Treatment of Peripheral Neuromas
• Auditory Evoked Potential
• Bevacizumab (Avastin™) for Oncologic Indications
• Electrical and/or Magnetic Stimulation, Pelvic Floor Muscles-Adult Urinary and Fecal Incontinence
• Genetic Test: Fanconi Anemia
• Genetic Test: Molecular Markers in Fine Needle Aspirates of the Thyroid
• Immune Globulin, Intravenous and Subcutaneous
• Intravenous Lidocaine or Ketamine for the Outpatient Management of Chronic Pain
• Lab Test: Identification of Microorganisms Using Nucleic Acid Probes
• Noninvasive Imaging Technologies to Detect Liver Fibrosis or Cirrhosis (Elastography)
• Patient-Specific Cutting Guides and Custom Knee Implants
• PET or PET/CT for Penile Cancer
• Pilot Policy: Telemedicine for Applied Behavioral Analysis in the Treatment of Autism Spectrum Disorder
• Preventive Services for Non-Grandfathered (PPACA) Plans: Bicycle Helmet Use for Children & Adoloscents, Counseling
• PREVENTIVE SERVICES FOR NON-GRANDFATHERED (PPACA) PLANS: DEPRESSION SCREENING IN ADOLESCENTS
• Preventive Services For Non-Grandfathered (Ppaca) Plans: Obesity In Children; Screening And Counseling
• Preventive Services for Non-Grandfathered (PPACA) Plans: Obesity Screening in Adults
• Preventive Services for Non-Grandfathered (PPACA) Plans: Overview
• Preventive Services for Non-Grandfathered (PPACA) Plans: Serum Lipids Screening
• Preventive Services for Non-Grandfathered (PPACA) Plans: Well-Woman Visits for Adult Women
• Proteomics, Evaluation of Ovarian (Adnexal) Masses (e.g., OVA1, ROMA)
• Pulmonary Arterial Hypertension, Pharmacological Treatment with Prostacyclin Analogues, Endothelin Receptors Antagonists, or Phosphodiesterase Inhibitors
• Radiofrequency Ablation, Osteoid Osteoma
• Rituximab (Rituxan), Off-label Use
• Tumor Vaccines
• Vertebroplasty, Percutaneous
• Whole Body Computed Tomography Scan as a Screening Test

Added 5/25/2021;

• Amniotic Membrane and Amniotic Fluid Injections
• Angioplasty/Stenting, Percutaneous, Carotid Artery
• Biofeedback as a Treatment of Headache
• Cardiac Rehabilitation
• Cerliponase Alfa (Brineura™)
• Daratumumab (Darzalex)
• Epiduroscopy
• Gastric Neurostimulation for Treatment of Gastric and/or Small Bowel Paresis
• Givosiran (GIVLAARI®)
• Laser Treatment of Congenital Port Wine Stain Hemangiomas
• Mastectomy, Male Gynecomastia
• Minimally Invasive Image-Guided Lumbar Decompression for Spinal Stenosis
• Mohs’ Micrographic Surgery
• PCSK9 Inhibitors (Evolocumab) (Alirocumab)
• Phrenic Nerve Stimulation for Central Sleep Apnea
• Prostate, Saturation Biopsy
• Ramucirumab (Cyramza™)
• Sacroplasty
• Skin and Soft Tissue Substitutes, Bio-Engineered Products
• Stem Cell Growth Factor, Romiplostim (Nplate)
• Transcatheter Mitral Valve Repair

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

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