BCBS Arkansas Medical Policy Updates – November 2022

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

November 2022 BCBS Arkansas Medical Policy Updates:

• Ablation Therapy, Radiofrequency and Cryoablation of Pulmonary Tumors
• Absorbable Nasal Implant for Treatment of Nasal Valve Collapse
• Adipose-Derived Stem Cells in Autologous Fat Grafting to the Breast
• Adoptive Immunotherapy
• Allergy Immunotherapy
• Aqueous Shunts and Devices for Glaucoma
• Asfotase alfa (Strensiq®)
• Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions
• Autonomic Nervous System Testing
• Biochemical Marker’s, Alzheimer’s Disease
• Brachytherapy, Breast
• Brachytherapy, Endobronchial
• Brachytherapy, Radioembolization of Primary & Metastatic Tumors of the Liver with Therapeutic Microspheres
• Brexanolone (Zulresso™)
• Chemodenervation, Botulinum Toxins
• Continuous Local Anesthetic Infusion Pumps (Disposable Pain Pumps)
• Cryosurgical Ablation of Breast Tumors, Benign and Malignant
• Cryosurgical Ablation of Pancreatic Cancer
• Cryosurgical Ablation of Renal Tumors
• Cytoreduction Surgery with Hyperthermic Intraperitoneal Chemotherapy
• Dexamethasone intraocular suspension (DEXYCU®)
• Digital Health Technologies: Diagnostic Applications
• Discectomy: Percutaneous and Percutaneous Endoscopic, Manual, Automated or Laser
• Electrical Stimulation, Occipital Nerve Stimulation for Treatment of Headaches
• Emapalumab-LZSG (Gamifant)
• Esketamine (SPRAVATO™)
• Extracranial-Intracranial Bypass Surgery in Cerebrovascular Disease
• Fecal Microbiota Transplantation for the Treatment of Clostridium Difficile
• Focal Treatments for Prostate Cancer
• Galectin Measurement
• Genetic Test: Allopurinol Sensitivity (HLA-B*5801)
• Genetic Test: Breast Ca; Risk Recurrence to Determine Need for Adjuvant Therapy (Oncotype DX)
• Genetic Test: Epilepsy
• Genetic Test: Fetal RHD Genotyping Using Maternal Plasma
• Genetic Test: HER2 Testing
• Genetic Test: Li-Fraumeni Syndrome
• Genetic Test: Macular Degeneration
• Genetic Test: Molecular Markers in Fine Needle Aspirates of the Thyroid
• Genetic Test: Molecular Testing for Germline BRIP1, RAD51C, and RAD51D Variants Associated with Ovarian Cancer
• Genetic Test: PALB2 Mutations
• Givosiran (GIVLAARI®)
• Glucose Monitoring, Continuous
• Golimumab (Simponi®)
• HDC & Allogeneic Stem &/or Progenitor Cell Support for Primitive Neuroectodermal Tumors (PNET) & Ependymoma
• HDC & Autologous Stem &/or Progenitor Cell Support for Primitive Neuroectodermal Tumors (PNET) & Ependymoma
• High Dose Chemotheraphy with Allogenic or Autologous Stem Cell and/or Progenitor Cell Support
• Hormone Pellet Implantation for Hormone Replacement Therapy
• Hyperhidrosis Treatment
• Intensity Modulated Radiation Therapy (IMRT)
• Interferon Gamma-1B
• Lab Test: Hepsin Biomarker Testing
• Lab Test: Identification of Microorganisms Using Nucleic Acid Probes
• Laser Interstitial Thermal Therapy for Brain Tumors
• Left Atrial Appendage, Closure Device, Percutaneous
• Low Level Laser Therapy (LLLT)
• Lyme Disease Intravenous Antibiotic Therapy and Associated Diagnostic Testing
• Magnetic Resonance Imaging (MRI) Targeted Biopsy of the Prostate
• Magnetic Resonance Spectroscopy
• Medical Technology Assessment, Non-Covered Services
• Microprocessor-Controlled Prostheses for the Lower Limb
• Mutation Molecular Analysis for Targeted Therapy in Patients With Non-Small-Cell Lung Cancer
• Navigated Transcranial Magnetic Stimulation
• Periurethral Bulking Agents for the Treatment of Urinary and Fecal Incontinence
• Peroral Endoscopic Myotomy (POEM) for Treatment of Esophageal Achalasia
• PET or PET/CT for Esophageal or Esophagogastric Junction (EGJ) Cancer
• 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)
• Preventive Services for Non-Grandfathered (PPACA) Plans: Alcohol Misuse Counseling and/or Screening
• Preventive Services For Non-Grandfathered (Ppaca) Plans: Cervical Cancer Screening
• Preventive Services for Non-Grandfathered (PPACA) Plans: Developmental Screening
• Preventive Services for Non-Grandfathered (PPACA) Plans: Overview
• PREVENTIVE SERVICES FOR NON-GRANDFATHERED (PPACA) PLANS: SKIN CANCER, BEHAVIORAL COUNSELING FOR PREVENTION
• Preventive Services for Non-Grandfathered (PPACA) Plans: Tubercolosis Screening in Infants, Children and Adoloscents
• Radiation Therapy, Real Time Intra-Fraction Target Tracking
• Rituximab (e.g., Rituxan) and Biosimilars – Non-Oncologic Indications
• Sleep Apnea and Other Pulmonary Diseases, Ventilation Support and Respiratory Assist Devices
• Spinal Cord Neurostimulation for Treatment of Intractable Pain
• Spinal Unloading Devices For Treatment Of Low Back Pain (Orthotrac Pneumatic Vest)
• Stem Cell Growth Factors, Erythropoiesis-Stimulating Agents (ESAs), Darbepoetin, Epoetin, Peginesatide
• Surgery for Morbid Obesity
• Synthetic Cartilage Implant for Joint Pain
• Testing for Drugs of Abuse or Drugs at Risk of Abuse including Controlled Substances
• Testosterone Replacement Therapy
• Transplant, Heart
• Transplant, Liver

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

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