BCBS South Carolina Medical Policy Updates – May 2019

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

May 2019 BCBS South Carolina Medical Policy Updates:

• Acupuncture and Dry Needling
• Adoptive Immunotherapy
• Alpha-Fetoprotein-L3 for Detection of Hepatocellular (Liver) Cancer
• ANA/ENA Testing
• Anesthesia Services
• Behavioral Health Guidelines
• Brachytherapy for Clinically Localized Prostate Cancer Using Permanently Implanted Seeds
• Breast Duct Endoscopy
• Cardiac Biomarkers for Myocardial Infarction
• Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting
• Cardiovascular Disease Risk Assessment
• CD 5 Complement Inhibitors
• Chronic Pulmonary Thromboendarterectomy
• Circulating Tumor DNA and Circulating Tumor Cells for Cancer Management (Liquid Biopsy)
• Diagnosis and Management of Idiopathic Environmental Intolerance (i.e., Clinical Ecology)
• Diagnosis and Medical Management of Obstructive Sleep Apnea Syndrome
• Diagnosis of Vaginitis including Multitarget PCR Testing
• Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures
• External Insulin Infusion Pump
• Extracorporeal Shock Wave Treatment for Plantar Faciitis and Other Musculoskeletal Conditions
• Familial Adenomatous Polyposis and MUYTH-Associated Polyposis Testing
• Fecal Analysis in the Diagnosis of Intestinal Dysbiosis
• Ferritin Testing
• Flow Cytometry
• Gene Expression Profiling and Protein Biomarkers for Prostate Cancer Management
• Gene Expression Profiling for Uveal Melanoma
• Gene Therapy for Inherited Retinal Dystrophy/Luxturna™
• General Genetic Testing, Germline Disorders
• General Genetic Testing, Somatic Disorders
• Genetic Cancer Susceptibility Panels Using Next Generation Sequencing
• Genetic Testing for Epilepsy
• Genetic Testing for Hereditary Breast and/or Ovarian Cancer Syndrome (BRCA1/BRCA2)
• Hematopoietic Stem-Cell Transplantation for Solid Tumors of Childhood
• High-Dose Rate Temporary Prostate Brachytherapy
• Hospital Medical Services (Inpatient and Observation) and Consultation
• Human Papillomavirus (HPV) Vaccines
• InflammaDry Test
• Intensity-Modulated Radiation Therapy (IMRT): Abdomen and Pelvis
• Intraoperative Neurophysiologic Monitoring (sensory-evoked potentials, motor-evoked potentials, EEG monitoring)
• JAK2 and MPL Mutation Analysis in Myeloproliferative Neoplasms
• Ketamine for the Treatment of Depression
• Laboratory and Genetic Testing for Use of 5-Fluorouracil in Patients With Cancer
• Light Therapy for Dermatologic Conditions
• Lipid Apheresis
• Lung and Lobar Lung Transplant
• Lyme Disease Testing
• Lynch Syndrome Testing
• Magnetic Resonance Spectroscopy
• Manipulation Under Anesthesia
• Measurement of Serum Antibodies to Infliximab and Adalimumab
• Melanoma Vaccines
• Methadone Treatment for Opiate Addiction
• Molecular Markers in Fine Needle Aspirates of the Thyroid
• Monoclonal Antibody Therapies for Migraine Prevention
• Occipital Nerve Stimulation
• Ocrelizumab (Ocrevus™)
• Opioid Antagonists Under Heavy Sedation or General Anesthesia as a Technique of Opioid Detoxification
• Orthoptic Training for the Treatment of Vision or Learning Disabilities
• Pancreatic Enzyme Testing for Acute Pancreatitis
• Partial Left Ventriculectomy
• Percutaneous Balloon Kyphoplasty and Mechanical Vertebral Augmentation
• Percutaneous Treatment of Fracture Non-Unions or Bone Defects with Autologous Bone Marrow with or without Demineralized Bone Matrix (DBM)
• Pharmacogenetic Testing
• Plasma HIV-1 RNA Quantification for HIV-1 Infection
• Pneumatic Compression Pumps for Treatment of Lymphedema
• Preventive Services for Non-Grandfathered (PPACA) Plans: USPSTF recommended services
• Prolotherapy
• Radiofrequency Ablation of Peripheral Nerves to Treat Pain
• Radiopharmaceutical Agents and Other In Vivo Diagnostic Aids
• Registered Nurses Practicing in Extended Roles
• Reproductive Techniques
• Rituximab
• Saturation Biopsy for Diagnosis and Staging of Prostate Cancer
• Screening for Lung Cancer Using CT Scanning
• Semi-Implantable Middle Ear Hearing Aid for Moderate to Severe Sensorineural Hearing Loss
• Serum Testing for Evidence of Mild Traumatic Brain Injury
• Serum Tumor Markers for Malignancies
• SIMPONI ARIA (golimumab injection for intravenous use)
• Skin Contact Monochromatic Infrared Energy as a Technique to Treat Cutaneous Ulcers, Diabetic Neuropathy and Miscellaneous Musculoskeletal Conditions
• Speculoscopy
• Stem-cell Therapy for Peripheral Arterial Disease
• Stereotactic Radiofrequency Pallidotomy for the Treatment of Parkinson’s Disease
• Surgery for Lymphedema
• Telehealth
• Testosterone Replacement Therapies
• Threshold Electrical Stimulation as a Treatment of Motor Disorders
• Transcranial Doppler Ultrasound
• Transjugular Intrahepatic Portosystemic Shunt (TIPS)
• Transmyocardial Revascularization
• Trastuzumab
• Unicondylar Interpositional Spacer as a Treatment of Unicompartmental Arthritis of the Knee
• Urinary Tumor Markers for Bladder Cancer
• Vasectomy Using a Polymeric Clip
• Vertebral Axial Decompression
• Viscocanalostomy and Canaloplasty
• Whole Gland Cryoablation of Prostate Cancer

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

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