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BCBS Horizon Medical Policy Updates – April 2021
Click here to view the Blue Cross Blue Shield Horizon Medical Policy Updates »
April 2021 BCBS Horizon Medical Policy Updates:
- Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses
- Agalsidase Beta (Fabrazyme)
- Ambulance and Medical Transport Services/ Ancillary Ambulance Items and Supplies
- Artificial Intervertebral Disc: Cervical Spine
- Artificial Intervertebral Disc: Lumbar Spine
- Artificial Pancreas Device Systems
- Atezolizumab (Tecentriq)
- Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions
- Axicabtagene Ciloleucel (Yescarta)
- Blepharoplasty
- Breast Pumps
- Cardiac Rehabilitation in the Outpatient Setting
- Cognitive Rehabilitation
- Colon Hydrotherapy
- Compression Stockings
- Computer-Assisted Navigation for Orthopedic Procedure
- Computerized 2-Lead Resting Electrocardiogram Analysis for the Diagnosis of Coronary Artery Disease
- Computerized Corneal Topography/Videokeratography
- Continuous Passive Motion Device
- Cooling Devices Used in the Outpatient Setting
- Corneal Collagen Cross-Linking
- Cutaneous Electrogastrography (EGG)
- DNA-Based Testing for Adolescent Idiopathic Scoliosis
- Electrical and Electromagnetic Stimulation for the Treatment of Arthritis
- Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures
- Endothelial Keratoplasty
- Epithelial Cell Cytology in Breast Cancer Risk Assessment and High-Risk Patient Management (Ductal Lavage and Suction Collection Systems)
- Evinacumab-dgnb (Evkeeza)
- Eyelid Thermal Pulsation for the Treatment of Dry Eye Syndrome
- Facet Joint Injections/Medial Branch Blocks
- Gas Permeable Scleral Contact Lens
- Gene Expression-Based Assays for Cancers of Unknown Primary
- Genetic Testing for Alzheimer Disease
- Genetic Testing for BRCA1 or BRCA2 for Hereditary Breast/Ovarian Cancer Syndrome and Other High-Risk Cancers
- Genetic Testing for Developmental Delay/Intellectual Disability, Autism Spectrum Disorder, and Congenital Anomalies
- Genetic Testing for Duchenne and Becker Muscular Dystrophy
- Genetic Testing for Familial Cutaneous Malignant Melanoma
- Genetic Testing for Helicobacter Pylori Treatment
- Genetic Testing for Hereditary Hemochromatosis
- Genetic Testing for Lynch Syndrome and Other Inherited Colon Cancer Syndromes
- Genetic Testing for Macular Degeneration
- Genetic Testing for Predisposition to Inherited Hypertrophic Cardiomyopathy
- Hip Resurfacing
- Hippotherapy
- Imlygic (Talimogene Laherparepvec)
- Implantation of Intrastromal Corneal Ring Segments
- Insulin Infusion Pumps
- Intraocular Radiation Therapy for Age-Related Macular Degeneration
- Intravitreal and Punctum Corticosteroid Implants
- Isatuximab-irfc (Sarclisa)
- Keratoprosthesis
- KRAS, NRAS, and BRAF Variant Analysis in Metastatic Colorectal Cancer
- Laboratory and Genetic Testing for Use of 5-Fluorouracil in Patients With Cancer
- Lisocabtagene maraleucel (Breyanzi)
- Low Intensity Pulsed Ultrasound Fracture Healing Device
- Measurement of Lipoprotein-Associated Phospholipase A2 in the Assessment of Cardiovascular Risk
- Medical Beds
- Microprocessor-Controlled Prostheses for the Lower Limb
- Molecular Analysis for Targeted Therapy or Immunotherapy for Non-Small-Cell Lung Cancer
- Molecular Testing for Variants Associated with Hereditary Ovarian Cancer
- Moxetumomab Pasudotox-tdfk (Lumoxiti)
- Myoelectric Prosthetic and Orthotic Components for the Upper Limb
- Ofatumumab (Arzerra)
- Omacetaxine Mepesuccinate (Synribo)
- Ophthalmologic Techniques that Evaluate the Posterior Segment for Glaucoma
- Optical Coherence Tomography (OCT) of the Anterior Eye Segment
- Outpatient Pulmonary Rehabilitation
- Patient-Controlled End Range of Motion Stretching Devices
- Photodynamic Therapy for Choroidal Neovascularization
- Phototherapy for Psoriasis
- Pneumatic Compression Pumps for Treatment of Lymphedema and Venous Ulcers
- Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis
- Powered Exoskeleton for Ambulation in Patients with Lower Limb Disabilities
- Prescription Digital Therapeutics for Substance Abuse
- Retinal Prosthesis
- Sebelipase alfa (Kanuma)
- Sensory Integration Therapy and Auditory Integration Therapy
- Serum Holotranscobalamin as a Marker of Vitamin B12 (Cobalamin) Status
- Sipuleucel-T (Provenge)
- Transcatheter Mitral Valve Repair
- Transpupillary Thermotherapy for Treatment of Choroidal Neovascularization
- Trastuzumab & Pertuzumab Agents (Herceptin, Ogivri, Kadcyla, Herzuma, Ontruzant, Herceptin Hylecta, Trazimera, Kanjinti, Enhertu, Perjeta, Phesgo)
- Trilaciclib (Cosela)
- Ultrasound in Pregnancy
- Viscocanalostomy and Canaloplasty
- Vision Therapy or Orthoptic Therapy for the Treatment of Visual Disorders or Learning Disabilities
- Vitiligo
- Wearable Cardioverter-Defibrillators
- Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders
- Whole-Body CT Screening
Click here to view the Blue Cross Blue Shield Horizon Medical Policy Updates »
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