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BCBS Excellus Medical Policy Updates – January 2023
Click here to view the Blue Cross Blue Shield BCBS Excellus Medical Policy Updates »
January 2023 BCBS Excellus Medical Policy updates:
- Allogeneic Hematopoietic (STEM) Cell Transplantation
- Alopecia (Hair Loss)
- Anorexiants; Contrave (naltrexone/bupropion ER), Qsymia TM (phentermine/topiramate ER), Saxenda (liraglutide), Wegovy (semaglutide) and Xenical®
- Applied Behavior Analysis for the Treatment of Autism Spectrum Disorders
- Auditory Processing Disorder (ADP) Testing
- Autologous Hematopoietic (Stem) Cell Transplantation
- Blood Modifiers
- Breast Reconstruction Surgery
- Cimziaâ (Certolizumab pegol) – for Ankylosing Spondylitis, Crohn’s Disease, Psoriatic Arthritis and Rheumatoid Arthritis
- Clinical Review Prior Authorizations (CRPA) Rx
- Comfort, Convenience, Custodial or Cosmetic Services
- Cosmetic and Reconstructive Procedures
- Cranial Orthotics
- Enbrel (etanercept) – for Ankylosing Spondylitis, Juvenile Idiopathic Arthritis, Plaque Psoriasis, Psoriatic Arthritis, and Rheumatoid Arthritis
- Gene Expression Analysis for Prostate Cancer Management
- Genetic Testing for Germline Mutations of the RET Proto-Oncogene in Medullary Carcinoma of the Thyroid
- Genetic Testing for Inherited Disorders
- Humira ® (adalimumab) – for Psoriasis, Rheumatoid Arthritis, Juvenile Idiopathic Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Hidradenitis Suppurativa, Crohn’s Disease, Ulcerative Colitis and Panuveitis
- Immune Checkpoint Inhibitor Clinical Review Prior Authorization (CRPA)
- Immunizations
- Inborn Errors of Metabolism (IEM) and Rare Genetic Diseases
- Inflammatory Conditions Clinical Review Prior Authorization (CRPA) Rx & Medical Drugs
- Intervertebral Disc Decompression: Laser (Laser Discectomy) and Radiofrequency Coblation (Disc Nucleoplasty) Techniques
- Intravenous Immune Globulin (IVIG) & Sub-Cutaneous Immune Globulin (SCIG) Therapy
- Lysis of Epidural Adhesions (Epidural Adhesiolysis)
- Management of Dry Eye Syndrome and Meibomian Gland Dysfunction (e.g., LipiFlow)
- Measurement of Serum Antibodies to Tumor Necrosis Factor Blockers
- Medically Necessary Services
- Oncology Biosimilar Drug Policy
- Oncology Clinical Review Prior Authorization (Oncology-CRPA) Rx Drugs
- Percutaneous Intradiscal Electrothermal Annuloplasty
- Posturography
- Prolotherapy
- Psychological Testing
- Remicade ®(infliximab), Infliximab, Renflexis ®(infliximab-abda)
- Sacroiliac Joint Fusion/Stabilization: Open and Percutaneous Methods
- Sleep Studies
- Spinal Manipulation Under Anesthesia
- Stelara (Ustekinumab) – for Crohn’s Disease, Plaque Psoriasis and Psoriatic Arthritis
- Temporomandibular Joint (TMJ) Disease
- Transcranial Doppler Ultrasound
- Treatment of Hirsutism/Hypertrichosis (Hair Removal)
Click here to view the Blue Cross Blue Shield BCBS Excellus Medical Policy Updates »
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