BCBS Louisiana Medical Policy Updates – July 2018

July 2018 BCBS Louisiana Medical Policy Updates:

• Advanced Therapies for Pharmacological Treatment of Pulmonary Hypertension
• Allergy Tests of Uncertain Efficacy
• Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms
• Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer
• Axial Lumbosacral Interbody Fusion
• Branded Dexamethasone Packs
• Cardiovascular Risk Panels
• Chromosomal Microarray Testing for the Evaluation of Pregnancy Loss
• Contrast-Enhanced Coronary Computed Tomography Angiography (CCTA) for Coronary Artery Evaluation
• Cryosurgical Ablation of Breast Fibroadenomas
• Cryosurgical Ablation of Primary or Metastatic Liver Tumors
• Daxbia (cephalexin)
• denosumab (Prolia)
• dupilumab (Dupixent)
• Endovascular Procedures for Intracranial Arterial Disease (Atherosclerosis and Aneurysms)
• Endovascular Stent Grafts for Abdominal Aortic Aneurysms
• Extended Release Topiramate Products
• Fentanyl Oral Transmucosal and Nasal Opioid Analgesics
• Gene Expression Profiling and Protein Biomarkers for Prostate Cancer Management
• Gene Therapy for Inherited Retinal Dystrophy
• Genetic Cancer Susceptibility Panels Using Next Generation Sequencing
• Genetic Testing for FLT3, NPM1, and CEBPA Variants in Cytogenetically Normal Acute Myeloid Leukemia
• Genetic Testing for Hereditary Breast and/or Ovarian Cancer Syndrome (BRCA1/BRCA2)
• Genetic Testing for Lipoprotein(a) Variant(s) as a Decision Aid for Aspirin Treatment
• Genetic Testing for Neurofibromatosis
• Hematopoietic Cell Transplantation for Autoimmune Diseases
• Hematopoietic Cell Transplantation for Central Nervous System Embryonal Tumors and Ependymoma
• Hematopoietic Cell Transplantation for Epithelial Ovarian Cancer
• Implantable Hormone Pellets
• Implantation of Intrastromal Corneal Ring Segments
• Ingestible pH and Pressure Capsule
• insulin glargine (Basaglar)- Retired Policy
• Insulins (Non-Long Acting Products)
• Melanoma Vaccines-Archived Policy
• mepolizumab (Nucala)
• Molecular Panel Testing of Cancers to Identify Targeted Therapies
• Multianalyte Assays with Algorithmic Analyses for Predicting Risk of Type 2 Diabetes-Archived Policy
• Occipital Nerve Stimulation
• Oral Non-Sedating Antihistamines and Singulair Products (Branded)
• Percutaneous Left-Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation
• Percutaneous Tibial Nerve Stimulation
• pramlintide (Symlin)
• Proprotein Convertase Subtilisin Kexin Type 9 (PCSK9) Inhibitors [alirocumab (Praluent), evolocumab (Repatha)]
• Proteogenomic Testing for Patients With Cancer (GPS Cancer Test)
• Rhofade (oxymetazoline)
• Ryvent (carbinoxamine)
• Sacral Nerve Neuromodulation/Stimulation
• Salivary Hormone Testing
• Select Inhaled Respiratory Agents
• Serum Antibodies for the Diagnosis of Inflammatory Bowel Disease
• Sinus Ostial Dilatation with Balloon Catheter for Rhinosinusitis
• Stem-cell Therapy for Peripheral Arterial Disease
• tesamorelin (Egrifta)
• Topical Immunomodulators (Elidel, Protopic, generics)
• Transcatheter Aortic Valve Implantation for Aortic Stenosis
• Transtympanic Micropressure Applications as a Treatment of Meniere Disease
• Treatment of Hyperhidrosis
• triamcinolone extended release intra-articular injection (Zilretta)
• Viscocanalostomy and Canaloplasty

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

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