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BCBS North Carolina Medical Policy Updates – June 2018
Click here to view the Blue Cross Blue Shield North Carolina Medical Policy Updates »
June 2018 Medical Policy Updates:
- Alemtuzumab(Lemtrada )
- Biofeedback as a Treatment of Pain
- Brachytherapy, Intracavitary Balloon Catheter for Brain Cancer
- Capsule Endoscopy, Wireless
- Cardiac Hemodynamic Monitoring in the Outpatient Setting
- Carotid Intimal-Medial Thickness
- Charged Particle Radiotherapy
- Diagnosis and Treatment of Sacroiliac Joint Pain
- Drug Testing in Pain Management and Substance Abuse Treatment
- Electrogastrography, Cutaneous
- Enhanced External Counterpulsation (EECP)
- Enteral Nutrition
- Epidural Steroid Injections for Back Pain
- Esophageal pH Monitoring
- External Defibrillators
- Facet Joint Denervation
- Fecal Analysis in the Diagnosis of Intestinal Dysbiosis
- Gastric Electrical Stimulation
- Genetic Testing for Alzheimer’s Disease
- Genetic Testing for Hereditary Hemochromatosis
- Genetic Testing for Lactase Insufficiency
- Genetic Testing for Rett Syndrome
- Immunization Guidelines
- Intensity Modulated Radiation Therapy (IMRT) for Sarcoma of the Extremities
- Intensity Modulated Radiation Therapy (IMRT) of Head and Neck
- Intensity Modulated Radiation Therapy for Tumors of the Central Nervous System
- Intensity-Modulated Radiation Therapy (IMRT) of the Prostate
- Intravenous Anesthetics for the Treatment of Chronic Pain
- Intravenous Anesthetics for the Treatment of Chronic Pain
- Natalizumab (Tysabri )
- Neural Therapy
- Pancreas Transplant
- Pemetrexed (Alimta)
- Peroral Endoscopic Myotomy for Treatment of Esophageal Achalasia
- Pricing and Adjudication Principles for Professional Providers
- Progenitor Cell Therapy for the Treatment of Damaged Myocardium Due to Ischemia
- Prolotherapy
- Radioembolization for Primary and Metastatic Tumors of the Liver
- Radiosurgery, Stereotactic Approach
- Repository Corticotropin (H.P. Acthar Gel)
- Sacral Nerve Neuromodulation/Stimulation for Pelvic Floor Dysfunction
- Small Bowel, Small Bowel with Liver, or Multivisceral Transplant
- Spinal Cord Stimulation
- TENS (Transcutaneous Electrical Nerve Stimulator)
- Zinplava (bezlotoxumab)
Added June 29th;
- Antiemetic Injection Therapy
- Beta Amyloid Imaging With Positron Emission Tomography for Alzheimer’s Disease
- Bone Mineral Density Studies
- Cabazitaxel (Jevtana)
- Cardiovascular Disease Risk Tests
- CAR-T Therapy
- Chemoembolization of the Hepatic Artery, Transcatheter Approach
- Cimzia (Certolizumab Pegol)
- Computer-Aided Evaluation of Malignancy with MRI of the Breast
- Cranial Electrotherapy Stimulation (CES) and Auricular Electrostimulation
- Cryosurgical Ablation of Miscellaneous Solid Tumors Other Than Liver, Prostate, or Dermatologic Tumors
- Cryosurgical Ablation of Primary or Metastatic Liver Tumors
- CT Perfusion Imaging of the Brain
- Daratumumab (Darzalex)
- Dopamine Transporter Imaging with Single Photon Emission Computed Tomography
- Elotuzumab (Empliciti)
- Endovascular Procedures for Intracranial Arterial Disease
- Endovascular Therapies for Extracranial Vertebral Artery Disease
- Erythropoiesis-Stimulating Agents (ESAs)
- Gender Confirmation Surgery and Hormone Therapy
- General Approach to Genetic Testing
- Genetic Testing for Cutaneous Malignant Melanoma
- Image-Guided Minimally Invasive Decompression (IG-MLD) for Spinal Stenosis
- Infusion Therapy in the Home
- Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)
- Interspinous Fixation (Fusion) Devices
- Laboratory Tests for Heart Transplant Rejection
- Liver Transplant and Combined Liver-Kidney Transplant
- Lumbar Spine Fusion Surgery
- Lutathera® (lutetium Lu 177 dotatate)
- Magnetic Resonance Imaging (MRI) Targeted Biopsy of the Prostate
- Magnetic Resonance Spectroscopy
- Magnetoencephalography/Magnetic Source Imaging
- Microprocessor-Controlled Prostheses for the Lower Limb
- MRI-Guided Focused Ultrasound (MRgFUS)
- Myocardial Sympathetic Innervation Imaging
- Nusinersen (SpinrazaTM)
- Occipital Nerve Stimulation
- Paclitaxel (Abraxane)®
- Paraspinal Surface Electromyography (SEMG)
- Patient-Specific Instrumentation (e.g., Cutting Guides) for Joint Arthroplasty
- Percutaneous Intradiscal Electrothermal Annuloplasty, Radiofrequency Annuloplasty, and Biacuplasty
- Pneumatic Compression Pumps for Treatment of Lymphedema and Venous Ulcers
- Polysomnography for Non‒Respiratory Sleep Disorders
- Positional Magnetic Resonance Imaging (MRI)
- Prostatic Urethral Lift
- Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors
- Rhinoplasty
- Screening for Vertebral Fracture with Dual X-ray Absorptiometry (DXA)
- Siltuximab (Sylvant)
- Surgery for Morbid Obesity
- Surgical Deactivation of Headache Trigger Sites
- Three Dimensional Printed Orthopedic Implants
- Topical Negative Pressure Therapy for Wounds
- Tumor-Treatment Fields Therapy
- Vagus Nerve Stimulation
- Vertebroplasty, Kyphoplasty, and Sacroplasty Percutaneous
- Voretigene Neparvovec-rzyl (Luxturna)
- White Blood Cell Growth Factors
Click here to view the Blue Cross Blue Shield North Carolina Medical Policy Updates »
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