BCBS Minnesota Medical Policy Updates – July 2019

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

July 2019 Medical Policy Updates:

• Agalsidase Beta
• Amino Acid-Based Elemental Formulas
• Angioplasty and/or Stenting for Intracranial Aneurysms and Atherosclerosis
• Breast Ductal Lavage and Fiberoptic Ductoscopy
• Cerliponase Alfa
• Computerized Dynamic Posturography
• Cryoablation of Solid Tumors
• Drug Testing for Substance Use Disorder and Chronic Pain Management
• Dynamic Spinal Visualization and Vertebral Motion Analysis
• Endoscopic Radiofrequency Ablation or Cryoablation for Barrett’s Esophagus
• Endovascular Stent Grafts for Abdominal Aortic Aneurysms
• Endovascular Stent Grafts for Disorders of the Thoracic Aorta
• Enzyme Replacement Therapy for the Treatment of Adenosine Deaminase Severe Combined Immune Deficiency (ADA-SCID)
• Esketamine
• Genetic Testing to Evaluate Patients with Developmental Delay/Intellectual Disability, Autism Spectrum Disorder, or Congenital Anoma
• Gynecomastia Surgery
• Hematopoietic Stem-Cell Transplantation for Non-Hodgkin Lymphoma
• Infliximab
• Laboratory and Genetic Testing for Use of 5-Fluorouracil (5-FU) in Patients with Cancer
• Photodynamic Therapy for Ocular Indications
• Pressure-Reducing Support Surfaces
• Progesterone Therapy to Reduce Preterm Birth in High-Risk Pregnancies
• Quantitative Electroencephalogram [QEEG] or Brain Mapping for Mental Health or Substance-Related Disorders
• Respiratory Syncytial Virus (RSV) Prophylaxis
• Responsive Neurostimulation for the Treatment of Refractory Focal (Partial) Epilepsy
• Rituximab
• Saliva Hormone Tests
• Sebelipase Alfa
• Selected Treatments for Varicose Veins of the Lower Extremities
• Site of Service for Selected Outpatient Procedures
• Spinal Unloading Devices: Patient-Operated
• Stem-Cell Therapy for Peripheral Arterial Disease
• Surface Electromyography (SEMG)
• Surgical Interruption of Pelvic Nerve Pathways for Treatment of Pelvic Pain (Primary and Secondary Dysmenorrhea)
• Traction Decompression of the Spine
• Transcatheter Mitral Valve Repair
• Transcranial Magnetic Stimulation
• Treatment of Obstructive Sleep Apnea and Snoring in Adults
• Tumor Treating Fields Therapy
• Whole Body Dual X-Ray Absorptiometry (DXA) to Determine Body Composition
• Wireless Gastric Motility Monitoring

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

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