BCBS Tennessee Medical Policy Updates – October 2018

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

October 2018 BCBS Tennessee Medical Policy Updates:

• Abatacept
• Applied Behavioral Analysis (ABA)
• Bortezomib
• Bortezomib (Velcade )
• C1 Esterase Inhibitor Subcutaneous (Human) (Haegarda®)
• Certolizumab Pegol
• Epoetin Alfa-epbx for ESRD (dialysis)
• Epoetin Alfa-epbx for non-ESRD (non-dialysis)
• Icatibant
• Lanreotide
• Occupational Therapy and Physical Therapy for Autism Spectrum Disorder
• Paclitaxel (Protein-Bound)
• Pasireotide Pamoate
• Pegfilgrastim-jmdb
• Percutaneous Electrical Nerve Stimulation (PENS) and Percutaneous Neuromodulation Therapy
• Surgical Treatment of Femoroacetabular Impingement
• Testosterone Pellets for Subcutaneous Implantation
• Tildrakizumab-asmn
• Tocilizumab (Intravenous)
• Tocilizumab (Intravenous)
• Trastuzumab
• Triptorelin Extended-Release Injectable Suspension
• Vedolizumab
• Vedolizumab

Added 10/31/2018;

• Anticoagulant Agents (Pradaxa, Savaysa)
• Aqueous Shunts and Stents for Glaucoma
• Bronchial Thermoplasty for Asthma (Alair)
• Cardiac Rehabilitation in the Outpatient Setting
• certolizumab pegol (Cimzia)
• Chimeric Antigen Receptor T cell Therapy (CAR-T)
• Confocal Laser Endomicroscopy
• Continuous or Intermittent Monitoring of Glucose in Interstitial Fluid
• Cryosurgery Ablation of Miscellaneous Solid Tumors other than Liver or Prostate Tumors or Breast Fibroadenomas
• Cytochrome p450 Genotyping
• daclizumab (Zinbryta)
• Deep Brain Stimulation
• Diagnosis and Treatment of Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis
• Digital Breast Tomosynthesis
• Drug Testing in Pain Management and Substance Abuse Treatment
• Electronic Brachytherapy for Nonmelanoma Skin Cancer
• Ergotamine/Dihydroergotamine Products
• Gene Therapy for Inherited Retinal Dystrophy
• Genetic Testing for FLT3, NPM1, and CEBPA Variants in Cytogenetically Normal Acute Myeloid Leukemia
• Genetic Testing for Mental Health Conditions
• Genetic Testing for Mitochondrial Disorders
• Hematopoietic Cell Transplantation for Acute Lymphoblastic Leukemia
• Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
• Human Growth Hormone
• Intense Pulsed Light Therapy
• KIF6 Genotyping for Predicting Cardiovascular Risk and/or Effectiveness of Statin Therapy
• Laser Treatment of Acne and Rosacea
• mecamylamine (Vecamyl)
• Nerve Fiber Density Measurement
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
• omalizumab (Xolair)
• Orthopedic Applications of Platelet-Rich Plasma
• Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Conditions
• baricitinib (Olumiant )
• fostamatinib (Tavalisse )
• Outpatient Pulmonary Rehabilitation
• Therapeutic Radiopharmaceuticals in Oncology
• penicillamine (Cuprimine) / trientine (Syprine)
• Percutaneous Discectomy
• Pharmacogenetic Testing for Pain Management
• Proton Pump Inhibitors (PPIs)
• pyrimethamine (Daraprim)
• Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors
• Recombinant and Autologous Platelet-Derived Growth Factors for Wound Healing and Other NonOrthopedic Conditions
• Salivary Hormone Testing
• Semi-Implantable and Fully Implantable Middle Ear Hearing Aids
• Serologic Diagnosis of Celiac Disease
• Serum Antibodies for the Diagnosis of Inflammatory Bowel Disease
• sodium oxybate (Xyrem)
• tasimelteon (Hetlioz)
• Thiazolidinediones (TZDs) and TZD Combination Drugs
• tofacitinib (Xeljanz/Xeljanz XR)
• Topical Actinic Keratosis Products
• Topical Anesthetics
• Topical Antifungals
• Transvaginal and Transurethral Radiofrequency Tissue Remodeling for Urinary Stress Incontinence
• Vectra DA Blood Test for Rheumatoid Arthritis
• Zyflo/Zyflo CR (zileuton)

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

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