BCBS Tennessee Medical Policy Updates – July 2018

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

July 2018 BCBS Tennessee Medical Policy Updates:

• Abatacept
• Angioplasty and/or Stenting for Intracranial Arterial Disease (IAD)
• Artificial Liver Assist Devices for the Treatment of Liver Conditions
• Atezolizumab
• Avelumab
• Benralizumab
• Biochemical Markers for Alzheimer’s Disease
• Breast Reconstructive and Symmetry Surgery Following Mastectomy
• Brentuximab Vedotin
• Brentuximab Vedotin
• Cabazitaxel
• Certolizumab Pegol
• Circulating Tumor DNA (Liquid Biopsy) and Circulating Tumor Cells
• Collagenase Clostridium Histolyticum
• Complementary and Alternative Medicine
• Corneal Topography/Computer-Assisted Photokeratoscopy
• Coronary Computed Tomography Angiography (CCTA)
• Cutaneous Electrogastrography (EGG)
• Darbepoetin Alfa
• Denosumab
• Dynamic Spinal Visualization
• Eculizumab
• Electrical Impedance Scanning of the Breast
• Endobronchial Valves
• Epoetin Alfa
• Fosnetupitant / Palonosetron
• Free Testosterone Testing
• Genetic Testing for Mitochondrial Disorders
• Genotyping for 9p21 Single Nucleotide Polymorphisms to Predict Risk of Cardiovascular Disease or Aneurysm
• Goserelin Acetate Implant
• Hemodialysis in the Home
• Histrelin Acetate for Central Precocious Puberty (CPP)
• Home Hyperalimentation Nutritional Support (Total Parenteral / Enteral Nutrition)
• Implantable Sinus Stents and Drug-eluting Implants for Postoperative Use Following Endoscopic Sinus Surgery and for Recurrent Sinus Disease
• Infliximab
• Irinotecan Liposome Injection
• Lanreotide
• Laser Assisted Uvulopalatoplasty (LAUP)
• Leuprolide Acetate for Depot Suspension
• Magnetic Resonance Imaging (MRI) of the Breast
• Mammography Screening
• Mastectomy for Gynecomastia
• Mentoplasty (Chin Augmentation, Genioplasty)
• Multi-gene Expression Assay for Predicting Recurrence in Colon Cancer
• Natalizumab
• Nerve Graft with Radical Prostatectomy
• Ocrelizumab
• Octreotide Acetate Long-Acting Dosage For
• Octreotide Acetate Long-Acting Dosage Form
• Omalizumab
• Orthoptic Training for the Treatment of Vision or Learning Disabilities
• Plasma Exchange
• Positron Emission Tomography (PET) for Miscellaneous Applications
• Proton or Helium Ion Beam (Charged Particle) Radiation Therapy
• Radiofrequency Ablation of the Renal Sympathetic Nerves as a Treatment for Resistant Hypertension
• Retinal Prosthesis
• Rhinomanometry and Acoustic Rhinometry
• Rituximab
• Salivary Testing for Steroid Hormone Levels
• Saturation Biopsy for Diagnosis and Staging of Prostate Cancer
• Sebelipase Alfa
• Spinal Unloading Devices for the Treatment of Low Back Pain
• Talimogene Laherparepvec
• Thermography
• Three-Dimensional (3D) Printed Orthopedic Implants
• Tildrakizumab-asmn
• Tocilizumab (Intravenous)
• Vedolizumab
• Vulvectomy

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

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