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Blue Cross Blue Shield Excellus August 2017 Medical Policy Updates

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Click here to view the Blue Cross Blue Shield Excellus August 2017 Medical Policy Updates »

Acupuncture, Auricular Electrostimulation (e.g., E-Pulse, P-Stim™) (PDF) Policy 8.01.20 (posted 8/9/17)

Behavioral Health Treatment for Gender Dysphoria: Gender Identity Disorder (GID), Intersex, Transexualism (PDF) Policy 3.01.15 (posted 8/9/17)

Bone Growth Stimulators (e.g., Electrical, Osteogenic, Sonic Accelerated Fracture Healing System – SAFHS, Ultrasonic) (PDF) Policy 7.01.40 (posted 8/9/17)

Cryotherapy, Cold Therapy, Ice Therapy (PDF) Policy 1.01.21 (posted 8/9/17)

Electrothermal Collagen Shrinkage for Orthopedic Conditions, Thermal Capsulorrhaphy (PDF) Policy 7.01.46 (posted 8/9/17)

Lumbar Traction: Vertebral Axial Decompression and Home Lumbar Traction Devices – ComfortTrac, Decompression Reduction Stabilization (DRS) System, HomeTrac, Orthotrac, VAX-D (PDF) Policy 1.01.50 (posted 8/9/17)

Minimally Invasive Techniques for Lumbar Interbody Fusion: Anterior Lumbar(ALIF), Axial Lumbar (AxiaLIF), Direct Lateral (DLIF), Extreme Lateral (XLIF), Laparoscopic Anterior Lumbar (LALIF), Posterior Lumbar (PLIF), Transforaminal Lumbar (TLIF) (PDF) Policy 7.01.83 (posted 8/9/17)

Pneumatic Compression Devices/Lymphedema Pump/Sleeve (e.g., Flexitouch™) (PDF) Policy 1.01.17 (posted 8/9/17)

Radiofrequency Tumor Ablation (PDF) Policy 7.01.32 (posted 8/9/17)

Abdominoplasty and Panniculectomy (e.g., Belt Lipectomy, Lipectomy, Tummy Tuck) (PDF) Policy 7.01.53 (posted 8/9/17)

Blepharoplasty/Eyelid Surgery with or without Levator Muscle Advancement (Pseudoptosis Surgery, Ptosis Surgery, Brow Lift) (PDF) Policy 7.01.55 (posted 8/9/17)

Dental Crowns and Veneers (PDF) Policy 13.01.02 (posted 8/9/17)

Dental Implants (PDF) Policy 13.01.01 (posted 8/9/17)

Dental Inlays and Onlays (PDF) Policy 13.01.03 (posted 8/9/17)

Periodontal Maintenance (PDF) Policy 13.01.05 (posted 8/9/17)

Periodontal Scaling and Root Planing (PDF) Policy 13.01.04 (posted 8/9/17)

Wireless Capsule Endoscopy/Imaging for Examination of the Gastrointestinal (GI) Tract: AGILE Patency Capsule, Given® Capsule Camera, PillCam SB, PillCam ESO (PDF) Policy 6.01.27 (posted 8/9/17)

Electrical Stimulation: Transcutaneous Electrical Nerve (TENS), Percutaneous Electrical Nerve (PENS), H-Wave and Interferential Stimulators (IFS), Percutaneous Neuromodulation Therapy, Bionicare® (PDF) Policy 1.01.01 (posted 8/9/17)

Limb Pneumatic Compression Devices for Venous Thromboembolism Prophylaxis: Triple Play VT®, Venodyne, VascuTherm2 (PDF) Policy 1.01.51 (posted 8/9/17)

Wheelchairs and Power Operated Vehicles (POVs) (e.g., Scooters) (PDF) Policy 1.01.16 (posted 8/9/17)

Implantable Bone Conduction Hearing Aids, Bone Anchored Hearing Aid (BAHA®), OBC bone anchored hearing aid system, Ponto Pro (PDF) Policy 7.01.77 (posted 8/9/17)

Genetic Testing for Cystic Fibrosis: CF Transmembrane Conductance Regulator (CFTR) (PDF) Policy 2.02.17 (posted 8/9/17)

Genetic Testing for Inherited Disorders: Alpha-1-Antitrypsin Deficiency, ALS – Amyotrophic Lateral Sclerosis, Lou Gehrig’s Disease, Angelman Syndromes, Becker Muscular Dystrophy, CADASIL, Charcot-Marie-Tooth Huntington’s Disease, Congenital Adrenal Hyperplasia, Duchenne Muscular Dystrophy – DMD, Dystonia, Factor V, Fanconi Anemia, Fragile X syndrome, Gaucher Disease, Hemophilia A and B, Myotonic Dystrophy, Neurofibromatosis, Phenylketonuria – PKU, Prader Willi, Sickle Cell, Tay-Sachs Disease, Thalassemia (PDF) Policy 2.02.03 (posted 8/9/17)

Cardiac Resynchronization Therapy (Biventricular Pacemakers) for the Treatment of Heart Failure (Bioimpedance, Dual Chamber Pacemaker) (PDF) Policy 7.01.58 (posted 8/9/17)

Intravascular Ultrasound (IVUS) (PDF) Policy 6.01.09 (posted 8/9/17)

Home Prothrombin Time Monitor (e.g., Acusure™, CoaguChek®, International Normalized Ratio [INR], Prothrombin Time [PTT], Protime, Rubicon®) (PDF) Policy 1.01.44 (posted 8/9/17)

Patient Lifts (e.g., Hoyer, Saralift), Seat Lift Chair Mechanisms and Ceiling Lifts (PDF) Policy 1.01.08 (posted 8/9/17)

Antiprothrombin Antibody Testing (PDF) Policy 2.02.40 (posted 8/9/17)

Biochemical Markers of Bone Turnover (e.g., Collagen Cross Links, Cross Laps, ITCP, N-telopeptides, NTx, Pyrilinks) (PDF) Policy 2.02.18 (posted 8/9/17)

Proteomics-Based Testing for the Evaluation of Ovarian (Adnexal) Masses: Ova1™ (PDF) Policy 2.02.43 (posted 8/9/17)

Screening for Vitamin D Deficiency (PDF) Policy 2.02.45 (posted 8/9/17)

Urinary Tumor Markers for Bladder Cancer: AccuDx, BTA Stat™, Fibrin/Fibrinogen Degradation Products (FDP), ImmunoCyt, Nuclear Matrix Protein (NMP-22), Urinary Bladder Cancer Antigen (UBC Rapid Test) (PDF) Policy 2.02.12 (posted 8/9/17)

Ambulance: Air (PDF) Policy 11.01.06 (posted 8/9/17)

Out of Area/Out of Network Services (PDF) Policy 11.01.13 (posted 8/9/17)

Neuropsychological Testing (PDF) Policy 2.01.50 (posted 8/9/17)

Intravascular Brachytherapy, Endovascular Radiation (PDF) Policy 6.01.15 (posted 8/9/17)

Mammography: Computer Aided Detection (CAD): Image Checker System, MammoReader, R2 Checker, Second Look, RapidScreen (PDF) Policy 6.01.23 (posted 8/9/17)

Placental and Umbilical Cord Blood as a Source of Stem Cells (PDF) Policy 7.01.48 (posted 8/9/17)

Cryosurgery for Prostate Cancer (PDF) Policy 7.01.01 (posted 8/9/17)

Pelvic Floor Electrical Stimulation (PFES) as a Treatment of Urinary or Fecal Incontinence, Intravaginal Stimulation (PDF) Policy 1.01.19 (posted 8/9/17)

Prostate Cancer Screening, Detection and Monitoring (e.g., Digital Rectal Exam – DRE, PCA3Plus, Prostate Specific Antigen – PSA, Prostatic Acid Phosphatase – Male PAP Test) (PDF) Policy 10.01.05 (posted 8/9/17)

Immunizations/Vaccines (e.g., Hepatitis A, Hepatitis B, Human Papillomavirus [HPV, Cervarix, Gardasil], Meningococcal, Pneumococcal [Pneumovax 23, Prevnar], Rotavirus [Rotarix], Varicella [Varivax], Varicella Zoster [Zostavax]) (PDF) Policy 2.01.42 (posted 8/9/17)

Click here to view the Blue Cross Blue Shield Excellus August 2017 Medical Policy Updates »

Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.

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