BCBS Louisiana Medical Policy Updates – December 2022

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

December 2022 BCBS Louisiana Medical Policy Updates:

• Anifrolumab (Saphnelo™)
• Automated Percutaneous and Percutaneous Endoscopic Discectomy
• Autonomic Nervous System Testing
• bempedoic acid Products (Nexletol™, Nexlizet™)
• Bevacizumab Products
• Breast Brachytherapy
• Brexafemme® (ibrexafungerp)
• brodalumab (Siliq™)
• Bronchial Valves
• C1 esterase inhibitor [recombinant] (Ruconest®)
• Cholic Acid Capsules (Cholbam™)
• Continuous Glucose Monitoring
• Deucravacitinib (Sotyktu )
• Digital Health Therapies for Substance Abuse
• Drug-Eluting Sinus Stents and Implants for Postoperative Use Following Endoscopic Sinus Surgery and for Recurrent Sinonasal Polyposis
• Entadfi (finasteride and tadalafil)
• Genetic Testing for Hereditary Pancreatitis
• Granulocyte Colony Stimulating Factor (G-CSF) Products
• guselkumab (Tremfya™)
• Helidac® (bismuth subsalicylate, metronidazole, tetracycline)
• infliximab (Remicade®
• infliximab-abda (Renflexis®)
• infliximab-axxq (Avsola®)
• infliximab-dyyb (Inflectra®)
• Invasive Prenatal (Fetal) Diagnostic Testing
• Ivacaftor (Kalydeco™)
• Laboratory Tests Post Transplant
• Lanreotide Products
• Light Therapy for Psoriasis
• Lucemyra™ (lofexidine)
• lumacaftor/ivacaftor (Orkambi)™
• Lung and Lobar Lung Transplant
• luspatercept-aamt (Reblozyl®)
• Lyrica CR®, generics (pregabalin extended release)
• Mavacamten (Camzyos )
• Metformin and Metformin Containing Products
• Nasal Allergy Medications
• nitisinone (Orfadin®, Nityr™, generics)
• obeticholic acid (Ocaliva®
• osilodrostat (Isturisa®)
• Ovarian and Internal Iliac Vein Endovascular Occlusion as a Treatment of Pelvic Congestion Syndrome
• pegvaliase-pqpz (Palynziq™)
• Pharmacologic Treatment of Off Episodes in Parkinson Disease
• Prostatic Urethral Lift
• Select Novel Drug Formulations
• sirolimus topical gel (Hyftor )
• Small Bowel Transplant, Small Bowel/Liver Transplant and Multivisceral Transplant
• Total Artificial Hearts and Implantable Ventricular Assist Devices
• Transurethral Water Vapor Thermal Therapy and Transurethral Water Jet Ablation (Aquablation) for Benign Prostatic Hypertrophy
• Trastuzumab Products
• Treatment of Hepatitis C with sofosbuvir/velpatasvir/voxilaprevir (Vosevi™)
• ustekinumab (Stelara®)
• Vivjoa  (oteseconazole)
• Zegalogue® (dasiglucagon)
• Zerviate™ (cetirizine ophthalmic solution)

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

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