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BCBS Louisiana Medical Policy Updates – October 2024
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Click here to view the Blue Cross Blue Shield BCBS Louisiana Medical Policy Updates »
October 2024 BCBS Louisiana Medical Policy Updates:
- Actigraphy
- Afamelanotide (Scenesse®)
- Amniotic Membrane and Amniotic Fluid
- apremilast (Otezla®)
- Artificial Intervertebral Disc: Cervical Spine
- Artificial Intervertebral Disc: Lumbar Spine
- Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions
- Automated Percutaneous and Percutaneous Endoscopic Discectomy
- avatrombopag (Doptelet®)
- Axial Lumbosacral Interbody Fusion
- Bioengineered Skin and Soft Tissue Substitutes
- Bronchial Thermoplasty for Asthma (Alair®)
- Cochlear Implant
- Confocal Laser Endomicroscopy
- Continuous Glucose Monitoring
- Contrast-Enhanced Coronary Computed Tomography Angiography (CCTA) for Coronary Artery Evaluation
- Coronary Computed Tomography Angiography With Selective Noninvasive Fractional Flow Reserve
- Cromolyn Nebulized Solution
- Deep Brain Stimulation
- denosumab (Prolia®)
- denosumab (Xgeva®)
- dextromethorphan/quinidine (Nuedexta®)
- difelikefalin (Korsuva )
- Dipeptidyl Peptidase-4 (DPP-4) Inhibitors, DPP-4 Inhibitor/Metformin Combination Drugs
- Efgartigimod alfa (Vyvgart®), Efgartigimod Alfa and Hyaluronidase- Human (Vyvgart® Hytrulo)
- Endovascular Therapies for Extracranial Vertebral Artery Disease
- Etranacogene Dezaparvovec (Hemgenix®)
- Experimental-Investigational Services
- Fecal Microbiota, live-jslm (Rebyota™)
- fostamatinib (Tavalisse™)
- Gender Reassignment Surgery
- Givinostat (Duvyzat™)
- Hematopoietic Cell Transplantation for Acute Lymphoblastic Leukemia
- Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
- Immune Prophylaxis for Respiratory Syncytial Virus
- Implantable Infusion Pump for Pain and Spasticity
- Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)
- Interspinous Fixation (Fusion) Devices
- Lifileucel suspension (Amtagvi™)
- Liver Transplant and Combined Liver-Kidney Transplant
- lusutrombopag (Mulpleta®)
- Lymphedema Pumps
- Mecamylamine (Vecamyl®)
- Methergine/Methylergonovine Tablets
- Neurodiagnostics
- Omaveloxolone (Skyclarys™)
- 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
- Oxybate Products (Xyrem®, Xywav™)
- Peanut (Arachis hypogaea) Allergen Powder-dnfp (Palforzia™)
- Percutaneous Tibial Nerve Stimulation
- Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis
- Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors
- ravulizumab (Ultomiris™)
- Riluzole (Tiglutik™, Exservan™)
- Risankizumab-rzaa (Skyrizi™)
- Select buprenorphine/naloxone Combination Products
- Select Topical Antibiotics/Combinations
- Semi-Implantable and Fully Implantable Middle Ear Hearing Aids
- Sparsentan (Filspari™)
- Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome
- Taurolidine and heparin catheter lock solution (Defencath®
- Tocilizumab (Actemra®)
- Topical Anesthetics
- Topical Antifungals
- Topical Pain Patches
- Transcatheter Pulmonary Valve Implantation
- Travoprost Implant (iDose®
- Treatment of Hyperhidrosis
- Vertebroplasty/Kyphoplasty
- Zileuton Products (Zyflo® /zileuton ER)
Click here to view the Blue Cross Blue Shield BCBS Louisiana Medical Policy Updates »
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