BCBS Florida Medical Policy Updates – January 2019

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

January 2019 Medical Policy Updates:

• Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening
• Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in
• Axicabtagene Ciloleucel (Yescarta) Infusion
• Balloon Ostial Dilation (Balloon Sinuplasty) and Implantable Devices
• Benralizumab (Fasenra)
• Bevacizumab (Avastin®) Injection
• Bio-Engineered Skin and Soft Tissue Substitutes; Amniotic Membrane and Amniotic Fluid
• Bortezomib Injection
• Burosumab-twza (Crysvita )
• Cardiac Monitoring Devices
• Clotting Factors and Coagulant Blood Products
• Cooling and Heating Devices Used in the Outpatient Setting
• Deep Brain Stimulation and Responsive Neurostimulation
• Edaravone (Radicava)
• Electroretinography
• Endovascular Procedures for Intracranial Arterial Disease (Atherosclerosis and Aneurysms) and Extracranial Vertebral Artery Disease
• Enteral Formulas
• Erythropoiesis Stimulating Agents
• Evoked Potentials, Intraoperative Neurophysiologic Monitoring, and Quantitative Electroencephalography (QEEG)
• External Insulin Infusion Pumps and Continuous Glucose Monitors
• Fosnetupitant-Palonosetron (Akynzeo) IV
• Gender Reassignment Surgery
• Genetic Testing
• Genetic Testing for Hereditary Breast or Ovarian Cancer
• Gonadotropin Releasing Hormone Analogs and Antagonists
• Granulocyte Colony Stimulating Factors
• Guselkumab (Tremfya ) Injection
• Hereditary Angioedema Drug Therapy
• Image-Guided Radiation Therapy
• Investigational Services
• Magnetic Resonance Imaging of the Breast
• Minimally Invasive Fusion Techniques
• Mogamulizumab-kpkc (Poteligeo®)
• Myoelectric Prosthetic and Orthotic Components for the Upper Limb
• Neuropsychological Testing
• NK-1 receptor antagonist injectable therapy (Emend®, Cinvanti®, Varubi®)
• Non-Covered Services
• Occipital Nerve Stimulation
• Orthotics
• Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Disorders
• Oxygen
• Patisiran (Onpattro™)
• Preventive Services
• Rituximab (Rituxan ) and Rituximab;hyaluronidase (Rituxan Hycela™)
• Sacral Nerve Neuromodulation/Stimulation
• Subtalar Arthroereisis
• Tildrakizumab-asmn (Ilumya )
• Tisagenlecleucel (Kymriah) Infusion
• Transcutaneous Electric Nerve Stimulation  (TENS)
• Treatments for Varicose Veins/Venous Insufficiency
• Tumor/Genetic Markers
• Vagus Nerve Stimulation
• Ventricular Assist Devices and Total Artificial Hearts
• Viscosupplementation, Hyaluronan Injections (e.g. Synvisc )
• Voretigene Neparvovec-rzyl (Luxturna) Injection

Added 1/28/2019;

• Alemtuzumab (Lemtrada™) IV
• Allogeneic Bone Marrow and Stem Cell Transplantation
• Asfotase alfa (Strensiq )
• Autologous Bone Marrow and Stem Cell Transplantation
• Axitinib (Inlyta®) Tablets
• Bezlotoxumab (Zinplava) Injection
• Binimetinib (Mektovi ) Tablet
• Botulinum Toxins
• Brentuximab (Adcetris®) Injection
• Clotting Factors and Coagulant Blood Products
• Deflazacort (Emflaza)
• Drugs and Biologics without a Medical Coverage Guideline (Orphan Drugs and Off-Label and Labeled Use of FDA Approved Drugs)
• Edaravone (Radicava)
• Elotuzumab (Empliciti ) Injection
• Encorafenib (Braftovi ) Capsule
• Eteplirsen (Exondys 51)
• Everolimus (Afinitor®, Afinitor Disperz®) Tablets
• Genetic Testing
• Gonadotropin Releasing Hormone Analogs and Antagonists
• Inotersen (Tegsedi™)
• Mogamulizumab-kpkc (Poteligeo®)
• Nab-Paclitaxel Injection (Abraxane®)
• Neuropsychological Testing
• Nintedanib (Ofev ) Oral Capsules
• Nusinersen (Spinraza™)
• Pazopanib (Votrient™) Tablets
• Pirfenidone (Esbriet®)
• Pomalidomide (Pomalyst ) Capsule
• Pyrimethamine (Daraprim)
• Sorafenib (Nexavar®) Tablets
• Sunitinib Malate (Sutent®) Capsules
• Temsirolimus (Torisel®) Injection
• Treatment of Hyperhidrosis
• Treatments for Varicose Veins/Venous Insufficiency
• Vedolizumab (Entyvio ) Infusion
• Vemurafenib (Zelboraf™)
• Venetoclax (Venclexta ) Tablet

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

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