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BCBS Arkansas Medical Policy Updates – October 2018
Click here to view the Blue Cross Blue Shield Arkansas Medical Policy Updates »
October 2018 BCBS Arkansas Medical Policy Updates:
- Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions
- Bone Growth Stimulation, Electrical, Adjunct to Spinal Fusion
- Capsaicin (Qutenza) for the Treatment of Post-Herpetic Neuralgia
- Digitization: Computer Enhanced X– Ray Analysis for Spinal Evaluation
- Direct Acting Antiviral Medications for Treatment of Chronic Hepatitis C
- Gastric Neurostimulation for Morbid Obesity
- Genetic Test: Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts & Leukoencephalopathy (CADASIL) (NOTCH3)
- Genetic Test: Lynch Syndrome and Inherited Intestinal Polyposis Syndromes
- Hepatic Tumors, Ablative Procedures (Percutaneous Ethanol Injections, Acetic Acid Injections, and Interstitial Laser Photocoagulation)
- 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
- Immune Globulin, Intravenous and Subcutaneous
- Lung Volume Reduction Surgery (LVRS)
- Magnetoencephalography/Magnetic Source Imaging
- Microwave Ablation of Tumors
- Minimally Invasive Lumbar Interbody Fusion
- Non-Myeloablative Allogeneic Stem Cell Transplantation
- Pain Management, Radiofrequency Facet Joint Denervation
- PET Scans (Positron Emission Tomography)
- Preventive Services For Non-Grandfathered (Ppaca) Plans: Visual Impairment Screening In Children
- Radiofrequency Ablation of Peripheral Nerves to Treat Pain Associated with Plantar Fasciitis or Knee Osteoarthritis
- Radiofrequency Ablation, Bony Metastases
- Sacral Nerve Stimulation for the Treatment of Neurogenic Bladder Secondary To Spinal Cord Injury
- Temporomandibular Joint Dysfunction
- Tumor Antigen, CA 125 (Carcinoembryonic Antigen 125)
- Vacuum Assisted Closure Device
Added 10/29/2018;
- Allergy Testing, Metal
- BCBS Arkansas Medical Policies
- Biomarker, Methotrexate Polyglutamates to Predict Response to Methotrexate in Patients with Rheumatoid Arthritis (Avise PG)
- Boron Neutron Capture Therapy
- Cardiac Event Recorder, Insertable Loop Recorder
- Coverage Policy Manual – Arkansas Blue Cross and Blue Shield
- Current Perception Threshold Test
- Electrophrenic Pacemaker (Diaphragmatic Pacemaker)
- Extracorporeal Shock Wave Therapy in the Treatment of Peyronie’s Disease
- Extracranial-Intracranial Bypass Surgery in Cerebrovascular Disease
- Fecal Microbiota Transplantation for the Treatment of Clostridium Difficile
- Fetal Fibronectin Enzyme Immunoassay
- Gender Reassignment Surgery for Gender Dysphoria
- Genetic Test: Molecular Testing of Tumors for Genomic Profiling as a Therapeutic Guide
- Genetic Test: Tamoxifen Treatment (CYP2D6)
- High Dose Chemotheraphy with Allogenic or Autologous Stem Cell and/or Progenitor Cell Support
- Hormone Pellet Implantation for Hormone Replacement Therapy
- Magnetic Resonance Imaging (MRI), Cardiac Applications
- Microwave Thermotherapy for Breast Cancer
- Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)
- Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux (VUR)
- PET or PET/CT for Small Cell Lung Cancer
- PET Scan for Multiple Myeloma, Plasmacytoma
- PET Scans (Positron Emission Tomography)
- PET Scans (Positron Emission Tomography)
- Plugs for Anal Fistula Repair
- Preventive Services for Non-Grandfathered (PPACA) Plans: Autism Screening
- Proteomics, Screening and Detection of Cancer (e.g., OvaCheck)
- Quantitative Electroencephalography as a Diagnostic Aid for Attention-Deficit/Hyperactivity Disorder
- Radiofrequency Ablation of Peripheral Nerves to Treat Pain Associated with Plantar Fasciitis or Knee Osteoarthritis
- Subconjunctival Retinal Prosthesis
- Testing for Drugs of Abuse or Drugs at Risk of Abuse including Controlled Substances
- Testosterone Replacement Therapy
- Tocolysis, Acute and Maintenance Therapy
- Transanal Endoscopic Microsurgery (TEMS/TAMIS)
- Transcatheter Arterial Chemoembolization (TACE) to Treat Primary or Metastatic Liver Malignancies
- Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric Disorders
- Tumor-Treating Fields Therapy for Glioblastoma (NovoTTF)
- Ultrafiltration in Decompensated Heart Failure
- Unicondylar Interpositional Spacer as a Treatment of Unicompartmental Arthritis of the Knee
Added 10/31/2018;
- Auditory Brain Stem Implant
- Responsive Neurostimulation for the Treatment of Refractory Partial Epilepsy
- Electrical/Electromagnetic Stimulation for the Treatment of Arthritis
- Etanercept (Enbrel)
- Genetic Test: Inherited Peripheral Neuropathies (Charcot Marie Tooth, HNPP)
- Hippotherapy
- Intensity Modulated Radiation Therapy (IMRT)
- Interferon Gamma-1B
- Intraoperative Radiation Therapy
- Nerve Graft for Patients Undergoing Radical Non-Nerve-Sparing Prostatectomy
- Neural Therapy
- Noninvasive Fractional Flow Reserve Using Computed Tomography Angiography
- Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)
- Powered Exoskeleton for Ambulation in Patients with Lower Limb Disabilities
- Preventive Services for Non-Grandfathered (PPACA) Plans: Contraceptive use and Counseling
- Preventive Services for Non-Grandfathered (PPACA) Plans: Overview
- Respiratory Syncytial Virus, Immune Prophylaxis with Palivizumab (Synagis)
Click here to view the Blue Cross Blue Shield Arkansas Medical Policy Updates »
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