BCBS Tennessee Medical Policy Updates – August 2022

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

August 2022 BCBS Tennessee Medical Policy Updates:

• Abatacept
• AbobotulinumtoxinA
• Ado Trastuzumab
• Allogeneic Processed Thymus Tissue-agdc (Rethymic®)
• Amivantamab-vmjw
• Anifrolumab-fnia (Saphnelo™)
• Asparaginase Erwinia chrysanthemi
• Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze)
• Atezolizumab
• Avelumab
• Axicabtagene Ciloleucel
• Azacitidine
• Bendamustine
• Bevacizumab for the Treatment of Neoplastic Disease
• Bioidentical Compounded Hormone Therapy
• Brolucizumab-dbll
• Burosumab-twza
• Calaspargase Pegol-mknl
• Canakinumab
• Casimersen
• Confocal Laser Endomicroscopy
• Coronary Computed Tomography Angiography (CCTA)
• Cranial Electrotherapy Stimulation
• Cryosurgical Ablation of Solid Tumors
• Cytochrome P450 Genotyping
• Daratumumab and hyaluronidase-fihj
• Darbepoetin Alfa for Dialysis (Aranesp®)
• Darbepoetin Alfa for Non-Dialysis (Aranesp®)
• Denosumab
• Diabetes Management
• Dostarlimab
• Edaravone
• Electromyography and Nerve Conduction Studies (Electrodiagnostic Assessment)
• Enfortumab Vedotin-ejfv
• Epoetin Alfa Products for Dialysis (Epogen®, Procrit®, Retacrit®)
• Epoetin Alfa Products for Non-Dialysis (Epogen®, Procrit®, Retacrit®)
• Eteplirsen
• Expanded Molecular Panel Testing of Cancers to Identify Targeted Therapies
• Gastric Electrical Stimulation
• Golodirsen
• High-Frequency Electrical Stimulation Pulses With/or Without a Low Dose Local Anesthetic for the Treatment of Pain
• Histrelin (Supprelin® LA)
• Idecabtagene Vicleucel (Abecma®)
• Idursulfase
• ildrakizumab-asmn
• IncobotulinumtoxinA
• Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers) – Interspinous Fixation (Fusion) Devices
• Intestinal Transplantation
• Ipilimumab
• Ixabepilone
• Lanreotide
• Laparoscopic, Percutaneous and Transcervical Techniques for the Myolysis of Uterine Fibroids
• Leuprolide Acetate for Depot Suspension
• Lisocabtagene Maraleuce
• Melphalan Flufenamide
• Melphalan Flufenamide (Pepaxto®)
• Nivolumab
• Noninvasive Techniques for Evaluation and Monitoring of Chronic Liver Diseases
• Octreotide Acetate Long-Acting Dosage Form
• Ofatunumab
• OnabotulinumtoxinA (Botox®)
• Palivizumab
• Palivizumab
• Pasireotide
• Pegloticase
• Pembrolizumab
• Pembrolizumab
• Pertuzumab
• Polatuzumab Vedotin
• Powered Exoskeleton for Ambulation in Individuals with Lower-Limb Disabilities
• Proteomic Testing for Targeted Therapy in Non-Small Cell Lung Cancer
• Remdesivir
• RimabotulinumtoxinB
• Risankizumab-rzaa
• Rituximab Products
• Romosozumab-aqqg
• Sensory and Auditory Integration Therapies
• Talimogene Laherparepvec
• Temsirolimus
• Tisagenlecleucel
• Tocilizumab (Intravenous)
• Trabectedin
• Trastuzumab Products
• Triptorelin (Triptodur®)
• Triptorelin Pamoate
• Ustekinumab
• Vedolizumab
• Viltolarsen
• Vutrisiran (Amvuttra™)
• Zoledronic Acid
• Zoledronic Acid

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

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