Blue Cross Blue Shield South Carolina October 2017 Medical Policy Updates

October 2017 Medical Policy Updates:

• Abatacept (Orencia®)
• Allergy Immunotherapy
• Allergy Testing
• Antineoplaston Therapy and Sodium Phenylbutyrate
• Aqueous Shunts and Devices for Glaucoma
• Catheter Ablation as Treatment for Atrial Fibrillation
• Chronic Intermittent Intravenous Insulin Therapy (CIIIT)
• Computed Tomography (CT) Perfusion Imaging of the Brain
• Concurrent Care
• Contraceptive Management
• Diagnosis and Management of Idiopathic Environmental Intolerance (i.e., Clinical Ecology)
• Electrocardiographic Body Surface Mapping
• Endometrial Ablation
• Endothelial Keratoplasty
• Epithelial Cell Cytology in Breast Cancer Risk Assessment and High-Risk Patient Management (Ductal Lavage and Suction Collection Systems)
• Genetic Testing for Cystic Fibrosis
• Genetic Testing for Inherited Thrombophilia
• Hemoglobin A1c
• InflammaDry Test
• Intensity-Modulated Radiotherapy of the Breast and Lung
• Intradialytic Parenteral Nutrition
• Lipid Panels
• Magnetic Esophageal Ring to Treat Gastroesophageal Reflux Disease (GERD)
• Non-contact Ultrasound Treatment of Wounds
• Ocriplasmin for Symptomatic Vitreomacular Adhesion
• Open and Thoracoscopic Approaches to Treat Atrial Fibrillation and Atrial Flutter (Maze and Related Procedures)
• Paraspinal Surface Electromyography (SEMG) to Evaluate and Monitor Back Pain
• Periureteral Bulking Agents for the Treatment of Vesicoureteral Reflux (VUR)
• Peroral Endoscopic Myotomy for Treatment of Esophageal Achalasia
• Plasma HIV-1 RNA Quantification for HIV-1 Infection
• Plugs for Fistula Repair
• Radiation Oncology Services
• Radioactive Seed Localization of Nonpalpable Breast Lesions
• Radioembolization for Primary and Metastatic Tumors of the Liver
• Radiofrequency Ablation of the Renal Sympathetic Nerves as a Treatment for Resistant Hypertension
• Recombinant and Autologous Platelet-Derived Growth Factors for Wound Healing and Other Non‒Orthopedic Conditions
• Retinal Telescreening for Diabetic Retinopathy
• Reverse Shoulder Arthroplasty
• Robotic Assisted Surgery – Reimbursement Policy
• Thyroid Disease Testing
• Transanal Endoscopic Microsurgery (TEMS)
• Urinary Tumor Markers for Bladder Cancer
• Vagal Nerve Blocking Therapy for Treatment of Obesity
• Wireless Capsule Endoscopy as a Diagnostic Technique in Disorders of the Small Bowel, Esophagus and Colon
• Women’s Preventive Services

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.