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BCBS Michigan Medical Policy Updates – May 2019
Click here to view the Blue Cross Blue Shield Michigan Medical Policy Updates »
May 2019 BCBS Michigan Medical Policy Updates:
- Accelerated Breast Irradiation after Breast-Conserving Surgery for Early Stage Breast Cancer and Breast Brachytherapy as Boost with Whole-Breast Irradiation
- Andexxa®(recombinant coagulation factor Xa, inactivated-zhzo injection)
- Automated Visual Evoked Potentials for Routine Vision Screening in Pediatrics
- Balloon Ostial Dilation for Treatment of Chronic Rhinosinusitis
- Bioimpedance Devices for Detection and Management of Lymphedema
- Blepharoplasty and Repair of Brow Ptosis
- Blue Cross and BCN utilization management medical drug list
- BMT – Hematopoietic Cell Transplantation for Primary Amyloidosis
- BMT- Hematopoietic Cell Transplantation (HCT) for CNS Embryonal Tumors and Ependymoma
- Bone Marrow – Hematopoietic Cell Transplant for Waldenström’s Macroglobulinemia
- Bone Marrow Transplant – Hematopoietic Cell Transplantation for Epithelial Ovarian Cancer
- Bone Marrow/Hematopoietic Cell Transplantation for Miscellaneous Solid Tumors in Adults
- Brachytherapy for Clinically Localized Prostate Cancer Using Permanently Implanted Seeds
- Cerebrospinal Fluid and Urinary Biomarkers of Alzheimer’s Disease
- Chelation Therapy, Including Off-Label Uses
- Chronic Intermittent Intravenous Insulin Therapy (CIIIT)
- Cognitive Rehabilitation
- Coherence Tomography (OCT) of the Middle Ear
- Composite Tissue Allotransplantation
- Computer-Aided Evaluation as an Adjunct to Magnetic Resonance Imaging of the Breast
- Computerized 2-lead Resting Electrocardiogram Analysis for the Diagnosis of Coronary Artery Disease
- Continuous Passive Motion Machine (CPM)
- Contrast-Enhanced Computed Tomography Angiography (CTA, CCTA, MDCT, MSCT) of the Heart and/or Coronary Arteries
- Corneal Liquid Bandage Lens for Corneal Epithelial Defects/Scleral Lenses
- Cosmetic and Reconstructive Surgery
- CPT Category III Codes-Noncovered Services
- Cryosurgical Ablation of Miscellaneous Solid Tumors Other Than Liver, Prostate, or Dermatologic Tumors
- CT (Computed Tomography) Perfusion Imaging of the Brain
- Defecography
- Drug Testing of Urine, Oral Fluids and Hair
- Echosclerotherapy for the Treatment of Varicose Veins
- Enteral Nutrition
- Extra-Aortic Counter-Pulsation Ventricular Assist System
- Extracranial Carotid Artery Stenting
- Facet Joint Denervation
- Fecal Incontinence—Investigational Treatments
- Femtosecond Laser in Keratoplasty
- Fetal Surgery for Prenatally Diagnosed Malformations
- Fusilev®(levoleucovorin)
- Genetic Testing – Analysis of MGMT Promoter Methylation in Malignant Gliomas
- Genetic Testing and Counseling
- Genetic Testing for Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia (ARVC/D)
- Genetic Testing for Cardiac Ion Channelopathies
- Genetic Testing for Cytochrome P450 Polymorphisms
- Genetic Testing for HLA-B 1502 before Carbamazepine Therapy
- Genetic Testing for Inherited Hypertrophic Cardiomyopathy
- Genetic Testing for Marfan Syndrome, Thoracic Aortic Aneurysms and Dissections, and Related Disorders
- Genetic Testing for Noonan Spectrum Disorder
- Genetic Testing for Pharmacogenetic Testing for Pain Management
- Genetic Testing of CADASIL Syndrome
- Genetic Testing-Gene Expression Profiling for Uveal Melanoma
- Immune Cell Function Assay
- Intravitreal Corticosteroid Implants
- Khapzory™(levoleucovorin)
- Libtayo®(cemiplimab-rwlc)
- Lumoxiti ™(moxetumomab pasudotox-tdfk)
- Obstructive Sleep Apnea and Snoring – Surgical Treatment
- Oral Surgery
- Percutaneous Tibial Nerve Stimulation
- Percutaneous Transluminal Angioplasty (PTA) for the Treatment of Cerebral Vasospasm
- Peripheral Subcutaneous Field Stimulation
- Photodynamic Therapy for Dermatologic Applications
- Positional Magnetic Resonance Imaging
- Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis
- Proteomic Testing for Targeted Therapy in Non-Small-Cell Lung Cancer (NSCLC), e.g., VeriStrat®
- Radioembolization for Primary and Metastatic Tumors of the Liver
- Radiofrequency Ablation of Miscellaneous Solid Tumors, Excluding Liver Tumors
- Recombinant and Autologous Platelet-Derived Growth Factors as a Treatment of Wound Healing and Other Non-Orthopedic Conditions
- Screening for Lung Cancer Using Computed Tomography Scanning or Chest Radiographs
- Serum Biomarker Human Epididymis Protein 4 (HE4)
- SpravatoTM(esketamine)
- Stand-Alone Ultrasound for Routine Breast Cancer Screening
- Suprachoroidal Delivery of Pharmacologic Agent
- Telemedicine
- Telemedicine
- Telemedicine
- Tumor Treating Fields Therapy
- Ultrafiltration in Decompensated Heart Failure
- Ultrasonographic Measurement of Carotid Intima-Medial Thickness as an Assessment of Subclinical Atherosclerosis
- Virtual Colonoscopy/CT Colonography
Click here to view the Blue Cross Blue Shield Michigan Medical Policy Updates »
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