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BCBS Michigan Medical Policy Updates – December 2018
Click here to view the Blue Cross Blue Shield Michigan Medical Policy Updates »
December 2018 BCBS Michigan Medical Policy Updates:
- Actemra ®(tocilizumab)
- Allografts for Nerve Repair
- Aqueous Shunts and Stents for Glaucoma
- Azedra ®(iobenguane I-131 intravenous injection)
- Bevacizumab, Avastin®(bevacizumab), Mvasi™(bevacizumab-awwb)
- BMT – Hematopoietic Cell Transplantation for Acute Myeloid Leukemia
- Botox® (onabotulinumtoxinA)
- Cimzia® (certolizumab pegol)
- Cinqair®(reslizumab)
- Crysvita ®(burosumab-twza injection)
- Esophageal Function Tests
- Fasenra™(benralizumab)
- Fusilev®(levoleucovorin)
- Gene Expression Profiling for Cutaneous Melanoma
- Genetic Testing and Counseling
- Genetic Testing-Chromosomal Microarray Testing for the Evaluation of Early Pregnancy Loss and Intrauterine Fetal Demise
- Hemlibra ® (emicizumab-kxwh)
- Hyaluronan (Hyalgan, Synvisc, Supartz, Orthovisc, Euflexxa, etc.) Injections
- Hyperbaric Oxygen Therapy, Systemic and Topical
- Ilumya™(tildrakizumab-asmn)
- Imlygic™ ( talimogene laherparepvec)
- Immune Globulin Replacement Therapy
- Inhaled Nitric Oxide (iNO)
- Intensity Modulated Radiation Therapy (IMRT) of the Breast and Lung
- Intensity Modulated Radiation Therapy (IMRT): Central Nervous System Tumors
- Intensity-Modulated Radiation Therapy (IMRT): Abdomen and Pelvis
- Intensity-Modulated Radiation Therapy (IMRT): Cancer of the Head and Neck or Thyroid
- Intensity-Modulated Radiation Therapy (IMRT): Cancer of the Head and Neck or Thyroid
- Intravitreal Injections for Retinal Conditions
- Keytruda ®(pembrolizumab)
- Khapzory ™(levoleucovorin)
- Luxturna™(voretigene neparvovec-rzyl)
- Medical Oncology Drug Class Policy
- Medications for Hereditary Angioedema
- Mircera® (methoxy polyethylene glycol-epoetin beta)
- Myoelectric Prosthetic Components for the Upper Limb
- Nucala® (mepolizumab)
- Omegaven ®(fish oil triglycerides)
- Onpattro™(patisiran)
- Orencia®(abatacept)
- Percutaneous Electrical Nerve Stimulation (PENS) and Percutaneous Neuromodulation Therapy (PNT)
- Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation
- Pharmacogenomic and Metabolite Markers for Patients Treated with Thiopurines
- Polymetabolite Urine Testing for Adenomatous Polyps
- Poteligeo®(mogamulizumab-kpkc intravenous injection)
- Powered Bone Marrow Aspiration and Biopsy Systems
- Prosthetic Devices
- Provenge®(sipuleucel-T)
- Quantitative Sensory Testing
- Radicava™(edaravone)
- Radioembolization for Primary and Metastatic Tumors of and Liver
- Retinal Polarization Scan (Retinal Birefringence Scanning)
- Retinal Telescreening for Diabetic Retinopathy
- Rituxan®(rituximab) , Rituxan Hycela®(rituximab and hyaluronidase human)
- Sleep Disorders, Diagnosis and Medical Management
- Somatostatin Analogs
- Somatostatin Analogs
- Somatostatin Analogs
- Somatostatin Analogs
- Spectral Analysis of Prostate Tissue
- Spinal Surgery: Automated Percutaneous and Endoscopic Discectomy
- ST2 Assay for Chronic Heart Failure
- Stereotactic Radiosurgery and Stereotactic Body Radiotherapy
- Sylvant®(siltuximab)
- Synribo®(omacetaxine)
- Tegsedi™(inotersen)
- Tegsedi™(inotersen)
- Testosterone Replacement Therapy
- Transanal Hemorrhoidal Dearterialization
- Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric/Neurologic Disorders
- Trogarzo™(ibalizumab-ulyk)
- Xerava ™(eravacycline)
- Xiaflex (collagenase clostridium histolyticum)
- Xolair®(omalizumab)
- Zilretta®(triamcinolone acetonice extended-release injectable suspension, for intra-articular use)
Click here to view the Blue Cross Blue Shield Michigan Medical Policy Updates »
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