BCBS Mississippi Medical Policy Updates – January 2019

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

January 2019 BCBS Mississippi Medical Policy Updates:

• Ablation Procedures for Peripheral Neuromas
• Adoptive Immunotherapy, Including Chimeric Antigen Receptor (CAR) T Cell Therapies
• Allergy Testing
• Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry
• Amniotic Membrane and Amniotic Fluid Injections
• Amyotrophic Lateral Sclerosis (ALS)
• Anabolic Steroids
• Analysis of MGMT Promoter Methylation in Malignant Gliomas
• Anti-Rheumatic Biologicals – Effective 04/01/2018
• Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer
• Automated Ambulatory Blood Pressure Monitoring for the Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure
• Avodart
• Bioengineered Skin and Soft Tissue Substitutes
• Brineura™ (cerliponase alfa)
• Carrier Screening for Genetic Diseases
• Chromoendoscopy as an Adjunct to Colonoscopy
• Chronic Plaque Psoriasis – Effective 04/01/2018
• Circulating Tumor DNA and Circulating Tumor Cells for Cancer Management (Liquid Biopsy)
• Computed Tomography (CAT Scan) and Computed Tomographic Angiography (CTA) of the Head and Neck
• Condylox
• Corneal Collagen Cross-linking
• Crohn’s Disease and Ulcerative Colitis – Effective 04/01/2018
• Cuprimine
• Cystic Fibrosis
• Deep Brain Stimulation
• Diagnosis and Management of Idiopathic Environmental Intolerance (i.e. Multiple Chemical Sensitivities)
• Diagnosis and Treatment of Sacroiliac Joint Pain
• Differin 0.3% Gel (adapalene)
• Digital Breast Tomosynthesis
• Dovonex Cream (calcipotriene)
• Durable Medical Equipment (DME)
• Endovascular Stent Grafts for Disorders of the Thoracic Aorta
• Epoetin Alfa (Procrit®, Epogen®) Darbepoetin Alfa (Aranesp®)
• Fluorouracil Cream
• Gastrocrom
• General Approach to Genetic Testing
• Genetic Cancer Susceptibility Panels Using Next-Generation Sequencing
• Genetic Testing
• Genetic Testing for FMR1 Mutations (including Fragile X Syndrome)
• Genetic Testing for Hereditary Breast/Ovarian Cancer Syndrome (BRCA1/BRCA2)
• Giant Cell Arteritis
• Hemophilia Factor VIII Factor IX Factor X
• Hereditary Angioedema (HAE)
• Hidradenitis Suppurativa (HS)
• Human Growth Hormone and Insulin-like Growth Factor-1
• Idiopathic Pulmonary Fibrosis
• Immunoglobulin Therapy
• Immunohistochemistry for Microscopic Evaluation of Prostate Biopsy
• Impavido (miltefosine)
• Ingestible pH and Pressure Capsule
• Injectable Asthma Agents
• Interferon alfa-2b (Intron A)
• Interferon alfa-n3 (Alferon N)
• Interferon Gamma-1b (Actimmune®)
• Intra-articular Hyaluronan Injections for Osteoarthritis
• Intradialytic Parenteral Nutrition
• Isotretinoin Products
• Lotronex
• Lumizyme® (alglucosidase alfa)
• Magnetic Resonance Imaging (MRI) of the Breast
• Magnetic Resonance Imaging-Targeted Biopsy of the Prostate
• Molecular Testing in the Management of Pulmonary Nodules
• Myoelectric Prosthetic and Orthotic Components for the Upper Limb
• Nasonex
• Noninvasive Prenatal Screening for Fetal Aneuploidies and Microdeletions Using Cell-Free Fetal DNA
• Non-invasive Techniques for the Evaluation and Monitoring of Patients With Chronic Liver Disease
• Novel Biomarkers in Risk Assessment and Management of Cardiovascular Disease
• Noxafil/Vfend
• Nuplazid (Pimavanserin)
• Ophthalmic Allergy/Anti-Inflammatory Medications
• Opioid and Opioid Combination Medications
• Oracea (doxycycline DR)
• Otezla® (apremilast)
• Oxygen
• Parenteral (PEN) and Enteral (EN) Nutrition Support in the Home
• Preventive Health Services
• Progesterone Therapy as a Technique to Reduce Preterm Delivery in High Risk Pregnancies
• Prosthetics
• Proteogenomic Testing for Patients With Cancer
• Radiofrequency Ablation of Primary or Metastatic Liver Tumors
• Relistor (methylnaltrexone bromide)
• Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy
• Retinal Prosthesis
• Rituxan (rituximab) Non-Oncology
• Sacral Nerve Neuromodulation/Stimulation
• Scintimammography and Gamma Imaging of the Breast and Axilla
• Selenium Sulfide Shampoo
• Sleep Disorders – Effective 01/01/2018
• Sleep Disorders – Effective 01/01/2018
• Sphenopalatine Ganglion Block for Headache
• Spinal Cord Stimulation
• Spinal Cord Stimulation
• Spinraza (Nusinersen)
• State and School Employees’ Health Insurance Plan – Telehealth: Participant-Initiated to Provider Online Evaluation and Management Services
• State and School Employees’ Health Insurance Plan – Telehealth: Real-Time Interactive Telemedicine Services
• State and School Employees’ Health Insurance Plan – Telehealth: Remote Patient Monitoring Services
• Telehealth: Real-Time Interactive Telemedicine Services
• Telehealth: Real-Time Interactive Telemedicine Services
• Telehealth: Remote Patient Monitoring Services
• Telehealth: Remote Patient Monitoring Services
• Telehealth: Store-and-Forward Telemedicine Services
• Telehealth: Store-and-Forward Telemedicine Services
• Temporomandibular Joint Disorder
• Total Artificial Hearts and Implantable Ventricular Assist Devices
• Treatment of Autism Spectrum Disorder (ASD)
• Urine Drug Testing in Chronic Pain Management and Substance Use Disorders Treatment
• Vagus Nerve Stimulation
• Vectical (calcitriol)
• Whole Gland Cryoablation of Prostate Cancer
• Xolair (omalizumab)
• Zyclara

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

Policy Alerts monitors Commercial and Medicare medical policies for changes. While medical Insurance carriers typically update medical policies annually, there are many reasons why they might review or update a policy. When reviews occur out of cycle they often go unnoticed. Policy Alerts keeps you updated when Payers make coverage changes to medical policies affecting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on medical Insurance decisions in real-time. When changes occur, instant email alerts are delivered to your inbox. Clients have access to detailed coverage reports and medical policies through the interactive Policy Alerts Dashboard portal. Save time each month and keep focused on important Payer medical policy reviews and coverage decisions affecting your business!

Policy Alerts takes a client-focused hands-on approach and is constantly working to provide our customers with helpful insights and actionable analytics. We understand what our clients need and are dedicated to providing timely, accurate, and always up-to-date reports.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or endorsement by them. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.