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BCBS Horizon

BCBS Horizon Medical Policy Updates – October 2018

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

October 2018 Medical Policy Updates:

  • Agalsidase Beta (Fabrazyme)
  • Allogeneic Pancreas Transplant
  • Assisted Reproductive Technologies
  • Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions
  • Belimumab (Benlysta)
  • Biofeedback
  • Botulinum Toxin
  • Chiropractic Review Policy
  • Composite Tissue Allotransplantation of the Hand and Face
  • Computed Tomography (CT) Perfusion Imaging of the Brain
  • Discography
  • Drug Therapy for Hereditary Angioedema [Cinryze Berinert Haegarda (Human C1 Inhibitor) Kalbitor (Ecallantide) Firazyr (Icatibant) Ruconest (C1 Esterase Inhibitor [Recombinant])]
  • Eculizumab (Soliris)
  • Epidural Steroid Injections
  • Epidurography Radiological Supervision and Interpretation
  • Facet Joint Injections or Medial Branch Blocks
  • First Trimester Screening for Chromosomal Abnormalities using Fetal Ultrasound Assessment of Nuchal Translucency Combined with Maternal Serum Assessment
  • Foot Care Services
  • Gait Trainers and Standing Frames
  • Gaucher Disease Therapy
  • Genetic Testing for Lynch Syndrome and Other Inherited Colon Cancer Syndromes
  • Gonadotropin-Releasing Hormone Analogs
  • Heart or Lung Transplant
  • Heart Transplant
  • Immune Globulin Subcutaneous (Vivaglobin Hizentra Gammagard Liquid Gamunex-C or Gammaked HyQvia and Cuvitru for Subcutaneous Administration)
  • Implantable Intrathecal Drug Delivery Systems
  • Injectable Bulking Agents for the Treatment of Urinary Incontinence
  • Intravenous Immunoglobulin (IVIG) Therapy
  • Invasive Prenatal (Fetal) Diagnostic Testing
  • Islet Transplantation
  • Isolated Small Bowel Transplant
  • Kidney Transplant
  • Laparoscopic and Percutaneous Techniques for the Myolysis of Uterine Fibroids
  • Laronidase (Aldurazyme) Galsulfase (Naglazyme) and Idursulfase (Elaprase) elosulfase alfa (Vimizim) and vestronidase alfa (Mepsevii)
  • Liver Transplant and Combined Liver-Kidney Transplant
  • Lung and Lobar Lung Transplant
  • Meniscal Allografts and Other Meniscal Implants
  • Multigene Expression Assay for Predicting Recurrence in Colon Cancer
  • Nivolumab (Opdivo)
  • Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome
  • Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence
  • Pemetrexed Disodium (Alimta)
  • Percutaneous Neurolysis for Trigeminal Neuralgia
  • Percutaneous Tibial Nerve Stimulation
  • Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux (VUR)
  • Pompe Disease Treatment with Myozyme (Alglucosidase alfa) and Lumizyme (Alglucosidase alfa)
  • Preimplantation Genetic Testing
  • Radiofrequency Joint Ablation or Denervation
  • Regional Sympathetic Blocks
  • Rhinomanometry and Acoustic or Optical Rhinometry
  • Sacroiliac Joint Injections
  • Scintimammography and Gamma Imaging of the Breast and Axilla
  • Serum Biomarker Tests for Multiple Sclerosis
  • Site of Service for Administration for Infusion and Injectable Prescription Medications
  • Small Bowel or Liver and Multivisceral Transplant
  • Spinal Cord and Implantable Peripheral Nerve Stimulators
  • Standards for Diagnostic Radiology or Imaging Facilities or Freestanding-Office including Surgi-Centers and Diagnostic Dental – Radiographic Imaging
  • Thermography
  • Total Artificial Hearts and Implantable Ventricular Assist Devices
  • Trastuzumab (Herceptin) Trastuzumab-dkst (Ogivri) and Ado-trastuzumab emtansine (Kadcyla)
  • Trigger Point Injections
  • Unna Boot
  • Ustekinumab (Stelara)
  • Vitrectomy Chair or Vitrectomy Support System or Face-Down Positioning Device for Post-Vitrectomy Positioning
  • Whole Body Dual X-Ray Absorptiometry (DEXA) to Determine Body Composition
  • Work Hardening or Conditioning Programs
  • Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions
  • Bioengineered Skin and Soft Tissue Substitutes
  • Bone Mineral Density Studies and Vertebral Fracture Assessment With Densitometry
  • Dermatologic Applications of Photodynamic Therapy
  • Erwinaze (Asparaginase Erwinia Chrysanthemi) and Oncaspar (pegaspargase)
  • Genetic and Protein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer
  • Hip Resurfacing
  • Non Oral Drug Therapy for Pulmonary Hypertension
  • Noninvasive Prenatal Screening for Fetal Aneuploidies and Microdeletions Using Cell-Free Fetal DNA
  • Obstetrical Ultrasound Policy
  • Photodynamic Therapy for Choroidal Neovascularization
  • Total Ankle Replacement (Arthroplasty)
  • Transplant Donor and Recipient Policy


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


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