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BCBS HealthNow NY December 2017 Medical Policy Updates

Click here to view the BCBS HealthNow NY Medical Policy Updates »

Protocol Revisions effective January 1, 2018

  • Cochlear Implant
  • Continuous or Intermittent Monitoring of Glucose in Interstitial Fluid
  • Diagnosis and Treatment of Sacroiliac Joint Pain
  • DNA-Based Testing for Adolescent Idiopathic Scoliosis
  • Gene Expression Testing to Predict Coronary Artery Disease
  • Genetic and Protein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer
  • Genetic Cancer Susceptibility Panels Using Next-Generation Sequencing
  • Genetic Testing for Alpha1-Antitrypsin Deficiency
  • Genetic Testing for Breast Cancer Gene Expression Prognosis Assay
  • Genetic Testing for Cystic Fibrosis
  • Genetic Testing for Developmental Delay and Autism Spectrum Disorder
  • Genetic Testing for Hereditary Breast and Ovarian Cancer Syndrome
  • Genetic Testing for Hereditary Hearing Loss
  • Genetic Testing for Leukemia and Lymphoma
  • Genetic Testing for Noninvasive Prenatal Testing
  • Genetic Testing for the Diagnosis of Inherited Peripheral Neuropathies
  • In Vitro Chemoresistance and Chemosensitivity Assays
  • Molecular Analysis for Targeted Therapy of Non-Small-Cell Lung Cancer
  • Oncologic Applications of Photodynamic Therapy, Including Barrett Esophagus
  • Open and Thoracoscopic Approaches to Treat Atrial Fibrillation and Atrial Flutter (Maze and Related Procedures)
  • Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Conditions
  • Ultrasound Accelerated Fracture Healing Device
  • Use of Common Genetic Variants (Single Nucleotide Polymorphisms) to Predict Risk of Nonfamilial Breast Cancer
  • Wearable Cardioverter Defibrillators


New Protocols effective January 1, 2018

  • Magnetic Resonance Imaging‒Targeted Biopsy of the Prostate


Protocols Reviewed Without Change

  • Ambulance (Emergency)
  • Biofeedback as a Treatment of Urinary Incontinence in Adults
  • Catheter Ablation as Treatment for Atrial Fibrillation
  • Chelation Therapy for Off-Label Uses
  • Circulating Tumor DNA and Circulating Tumor Cells for Cancer Management (Liquid Biopsy)
  • Computer-Assisted Navigation for Orthopedic Procedure (Formerly Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure)
  • Continuous Passive Motion in the Home Setting
  • Cryosurgical Ablation of Miscellaneous Solid Tumors Other Than Liver, Prostate, or Dermatologic Tumors
  • Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty)
  • Diagnosis and Management of Idiopathic Environmental Intolerance and Intracellular Micronutrient Analysis
  • Dopamine Transporter Imaging With Single-Photon Emission Computed Tomography (Formerly
  • Dopamine Transporter Single-Photon Emission Computed Tomography)
  • Endometrial Ablation
  • Endoscopic Radiofrequency Ablation or Cryoablation for Barrett Esophagus
  • Endovascular Procedures for Intracranial Arterial Disease (Atherosclerosis and Aneurysms)
  • Endovascular Stent Grafts for Abdominal Aortic Aneurysms
  • Enhanced External Counterpulsation
  • Extracorporeal Photopheresis
  • Facet Arthroplasty
  • General Approach to Evaluating the Utility of Genetic Panels
  • General Approach to Genetic Testing
  • Genetic Testing for Epilepsy
  • Genetic Testing for FAP and Lynch Syndrome
  • Genetic Testing for Statin-Induced Myopathy
  • Hematopoietic Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS Syndrome (Formerly Hematopoietic Stem Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS Syndrome)
  • Hematopoietic Cell Transplantation for Waldenström Macroglobulinemia (Formerly Hematopoietic Stem
  • Cell Transplantation for Waldenström Macroglobulinemia)
  • Implantable Bone-Conduction and Bone-Anchored Hearing Aids
  • Intradialytic Parenteral Nutrition
  • KIF6 Genotyping for Predicting Cardiovascular Risk and/or Effectiveness of Statin Therapy
  • Lung Volume Reduction Surgery for Severe Emphysema
  • Meniscal Allografts and Other Meniscal Implants
  • Myoelectric Prosthetic Components for the Upper Limb
  • Occlusion of Uterine Arteries Using Transcatheter Embolization
  • Orthopedic Applications of Platelet-Rich Plasma
  • Percutaneous Intradiscal Electrothermal Annuloplasty, Radiofrequency Annuloplasty, and Biacuplasty (Formerly Percutaneous Intradiscal Electrothermal Annuloplasty and Percutaneous Intradiscal Radiofrequency Annuloplasty)
  • Pharmacogenomic and Metabolite Markers for Patients Treated With Thiopurines
  • Plasma Exchange
  • Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis
  • Preimplantation Genetic Testing
  • Prolotherapy
  • Radiofrequency Ablation of Primary or Metastatic Liver Tumors
  • Reconstructive Breast Surgery/Management of Breast Implants
  • Sacral Nerve Neuromodulation/Stimulation
  • Saturation Biopsy for Diagnosis, Staging, and Management of Prostate Cancer
  • Semi-Implantable and Fully Implantable Middle Ear Hearing Aids
  • Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric/Neurologic Disorders
  • Transcutaneous Electrical Nerve Stimulation
  • Transmyocardial Revascularization
  • Treatment of Hyperhidrosis
  • Tumor Treatment Fields Therapy for Glioblastoma
  • Urinary Tumor Markers for Bladder Cancer
  • Vagus Nerve Stimulation
  • Vectra® DA Blood Test for Rheumatoid Arthritis
  • Wireless Capsule Endoscopy to Diagnose Disorders of the Small Bowel, Esophagus, and Colon (Formerly
  • Wireless Capsule Endoscopy as a Diagnostic Technique in Disorders of the Small Bowel, Esophagus, and Colon)


Click here to view the BCBS HealthNow NY Medical Policy Updates »


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