BCBS Michigan Medical Policy Updates – July 2021

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

July 2021 BCBS Michigan Medical Policy Updates:

• Absorbable Nasal Implant for Treatment of Nasal Valve Collapse
• Actigraphy
• Allergy Testing and Immunotherapy
• Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening
• Antigen Leukocyte Antibody Test
• Artificial Pancreas Device Systems
• Bariatric Surgery (Gastric Surgery for Morbid Obesity)
• Breast Elastography – Ultrasound or Magnetic Resonance
• Cataract Removal Surgery
• Combined Heart/Liver Transplantation
• Comprehensive Gait Analysis
• Confocal Laser Endomicroscopy
• Continuous Intraocular Pressure Monitoring
• Corneal Hysteresis Measurement for Glaucoma
• CPT Category III Codes-Noncovered Services
• Dopamine Transporter Imaging with Single Photon Emission Computed Tomography (DaTscan™)
• Double Balloon Enteroscopy
• Dynamic Posturography
• Electroconvulsive Therapy
• Endovenous Ablation for the Treatment of Varicose Veins (e.g., ClariVein®, VenaSeal™ Closure System)
• Ex Vivo Lung Perfusion (EVLP)
• Galectin-3 Testing in the Assessment and Management of Chronic Heart Failure
• Gene Expression Profiling for Cutaneous Melanoma
• Genetic Testing – DNA Based Testing for Adolescent Idiopathic Scoliosis
• Genetic Testing – NGS Testing of Multiple Genes (Panel) to Identify Targeted Cancer Therapy
• Genetic Testing (Single Nucleotide Variants) to Predict Risk of Nonfamilial Breast Cancer
• Genetic Testing for Alzheimer’s Disease
• Genetic Testing for Amyotrophic Lateral Sclerosis
• Genetic Testing for Familial Cutaneous Malignant Melanoma (CDKN2A)
• Genetic Testing for Heterozygous Familial Hypercholesterolemia
• Genetic Testing for Lynch Syndrome and Other Inherited Colon Cancer Syndromes
• Genetic Testing for Myotonic Dystrophy
• Genetic Testing for Prader-Willi and Angelman Syndromes (Chromosome 15 Abnormalities)
• Genetic Testing for Retinal Dystrophies
• Genetic Testing for Rett Syndrome
• Genetic Testing for Tay-Sachs Disease
• Genetic Testing for the Diagnosis of Inherited Peripheral Neuropathies
• Genetic Testing-Human Platelet Antigen Genotyping
• Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins During Breast-Conserving  Surgery (e.g., MarginProbe )
• Infuse/Mastergraft Posterolateral Revision Device
• Intraoperative Radiotherapy
• Lumbar Traction Devices for The Treatment of Low Back Pain
• Magnetoencephalography/Magnetic Source Imaging
• Methotrexate (MTX) Polyglutamate Testing To Measure Response To Methotrexate Therapy
• Multimarker Serum Testing Related to Ovarian Cancer (e.g., OVA1®, Overa™ and ROMA™ testing)
• Near-Infrared Spectroscopy-Intravascular Coronary Imaging
• Orthopedic Applications of Platelet-Rich Plasma
• Orthopedic Applications of Stem-Cell Therapy (Including Allografts and Bone Substitutes Used With Autologous Bone Marrow)
• Positive Pressure Airway Devices
• Positron Emission Tomography (PET) for Miscellaneous Applications (Non-Cardiac, Non-Oncologic)
• Powered Bone Marrow Aspiration and Biopsy Systems
• Quantitative Pupillometry/Pupillography
• Screening for Lung Cancer Using Computed Tomography Scanning or Chest Radiographs
• Sleep Disorders- Diagnosis and Medical Management
• SPECT/CT Fusion Imaging

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

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