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Blue Cross Blue Shield Massachusetts August 2017 Medical Policy Updates

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

 

These are the most recent policy updates.

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NEW MEDICAL POLICIES:

  • None

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REVISED MEDICAL POLICIES:

  • Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions
  • Bioengineered Skin and Soft Tissue Substitutes
  • Cardiac Rehabilitation in the Outpatient Setting
  • Circulating Tumor DNA and Circulating Tumor Cells for Cancer Management (Liquid Biopsy)
  • Coronary Computed Tomography Angiography with Selective Noninvasive Fractional Flow Reserve
  • Genetic Testing of Mitochondrial Disorders
  • Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Conditions
  • Routine Foot Care and Debridement of Nails
  • High Tech Radiology
  • Computed Tomography (CT) Lower Extremity
  • Computed Tomography (CT) Neck for Soft Tissue Evaluation
  • Computed Tomography (CT) Thoracic Spine
  • Computed Tomography (CT) Upper Extremity
  • CT Angiography (CTA) and MR Angiography (MRA) Pelvis
  • Magnetic Resonance Imaging (MRI) of the Lower Extremity Joint and Non-Joint prn.pdf
  • Magnetic Resonance Imaging (MRI) Orbit, Face & Neck (Soft Tissues)
  • Magnetic Resonance Imaging (MRI) Upper Extremity (Any Joint)

HIGH TECH RADIOLOGY

  • Radiology policies are being reviewed. Medically necessary guidelines will be revised. Effective November 20, 2017

SLEEP DISORDER

  • Sleep disorder management policies are being reviewed. Medically necessary guidelines will be revised. Effective November 20, 2017
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CLARIFICATIONS TO MEDICAL POLICIES:
  • Bronchial Valves
  • Computed Tomographic Angiography Coronary Arteries (CCTA)
  • Computed Tomography (CT) Cardiac (Structure)
  • Computed Tomography (CT) CT Colonography (Virtual Colonoscopy)
  • Magnetic Resonance Spectroscopy
  • MR Angiography (MRA) Spinal Canal
  • Positron Emission Tomography (PET) Myocardial Imaging
  • Positron Emission Tomography, Other PET Applications, Including Oncologic Tumor Imaging
  • Proteomic Testing for Targeted Therapy in Non-Small-Cell Lung Cancer

 

Table of Contents
RETIRED MEDICAL POLICIES:
  • Hematopoietic Stem Cell Transplantation for Breast Cancer

 

 

Click here to view the Blue Cross Blue Shield Massachusetts 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.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!

Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.

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