BCBS South Carolina Medical Policy Updates – July 2018

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July 2018 BCBS South Carolina Medical Policy Updates:

• Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses
• Advanced Therapies for Pharmacologic Treatment of Pulmonary Hypertension
• Allogeneic Hematopoietic Stem-Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms
• Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry
• Auditory Brainstem Implant
• Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions
• Automated Ambulatory Blood Pressure Monitoring for the Diagnosis of Hypertension in Patients With Elevated Office Blood Pressure
• Automated Point-of-Care Nerve Conduction Tests
• Beta Amyloid Imaging with Positron Emission Tomography (PET) for Alzheimer’s Disease
• Brain Natriuretic Peptide (BNP)
• Cardiac Applications of PET Scanning
• Cervical Decompression and Fusion Procedures
• Chelation Therapy for Off-Label Uses
• Chromoendoscopy as an Adjunct to Colonoscopy
• Chromosomal Microarray Analysis
• Circulating Tumor DNA and Circulating Tumor Cells for Cancer Management (Liquid Biopsy)
• Cochlear Implant
• Colorectal Cancer Screening
• Computed Tomography to Detect Coronary Artery Calcification
• Confocal Laser Endomicroscopy
• Conjunctival Incision with Posterior Juxtascleral Placement of Anecortave Acetate Depot Suspension
• Contraceptive Management
• Corporate Administrative/Medical Policy Guidelines (Medical Necessity, Investigational/Experimental)
• Decompression of the Intervertebral Disc Using Laser (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty™)
• Deep Brain Stimulation
• Diagnosis and Medical Management of Obstructive Sleep Apnea Syndrome
• DNA Ploidy Cell Cycle Analysis
• Drug Coverage
• Electrical Stimulation for the Treatment of Arthritis
• Electrostimulation and Electromagnetic Therapy for the Treatment of Chronic Wounds
• Endoscopic Laser for Gastrointestinal Bleeding
• Endoscopic Radiofrequency Ablation or Cryoablation for Barrett’s Esophagus
• Endovascular Stent Grafts for Abdominal Aortic Aneurysms
• Erectile Dysfunction
• Esophageal pH Monitoring
• Fecal Microbiota Transplantation
• Gene Expression‒Based Assays for Cancers of Unknown Primary
• Genetic Testing for Alpha-1 Antitrypsin Deficiency
• Genetic Testing for Cystic Fibrosis
• Genetic Testing for FLT3 and NPM1 Mutations in Acute Myeloid Leukemia
• Genetic Testing for Mental Health Conditions
• Genetic Testing for PTEN Hamartoma Tumor Syndrome
• Heart Transplant
• Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
• Hematopoietic Stem-Cell Transplantation for Non-Hodgkin Lymphomas
• Hepatitis C testing
• HIV Genotyping and Phenotyping
• Insulin Potentiation Therapy
• Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)
• Interspinous Fixation (Fusion) Devices
• Interventions for Progressive Scoliosis
• Intracoronary Doppler Ultrasound
• Intravenous Antibiotic Therapy and Associated Diagnostic Testing for Lyme Disease
• Isolated Small Bowel Transplant
• Lung Volume Reduction Surgery for Severe Emphysema
• Magnetic Resonance‒Guided Focused Ultrasound
• Marfan Syndrome Testing
• Meniscal Allografts and Other Meniscal Implants
• Minimally Invasive Coronary Artery Bypass Graft Surgery
• Molecular Panel Testing of Cancers to Identify Targeted Therapies
• Multigene Expression Assay for Predicting Recurrence in Colon Cancer
• Myoelectric Prosthesis Components for the Upper Limb
• Oral Screening, Lesion Identification Systems and Genetic Screening
• Orthognathic Surgery
• Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Disorders
• Pathogen Panel Testing
• PET Scanning in Oncology to Detect Early Response during Treatment
• Preventive Services for Non-Grandfathered (PPACA) Plans: USPSTF recommended services
• Proteogenomic Testing for Patients With Cancer (GPS Cancer™ Test)
• Quantitative Sensory Testing
• Quantose Impaired Glucose Tolerance (IGT) Test
• Sacral Nerve Neuromodulation/Stimulation
• Scintimammography and Gamma Imaging of the Breast and Axilla
• SIMPONI ARIA (golimumab injection for intravenous use)
• Sublingual Immunotherapy as a Technique of Allergen-Specific Therapy
• Suit Therapy
• Surgical Treatment of Femoroacetabular Impingement
• Unicondylar Interpositional Spacer as a Treatment of Unicompartmental Arthritis of the Knee
• Whole Body Computed Tomography Scan as a Screening Test
• Whole Exome and Whole Genome Sequencing for Diagnosis of Patients With Suspected Genetic Disorders
• Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome

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