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Blue Shield California January 2018 Medical Policy Updates

Click here to view the Blue Shield California Medical Policy Updates »

January 2018 Medical Policy Updates:

• Accelerated Breast Irradiation and Brachytherapy Boost After Breast-Conserving Surgery for Early-Stage Breast Cancer
• Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses
• Allogeneic Hematopoietic Cell Transplantation for Genetic Diseases and Acquired Anemias
• Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms
• Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening
• Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer
• Biofeedback as a Treatment of Chronic Pain
• Biofeedback as a Treatment of Fecal Incontinence or Constipation
• Biofeedback as a Treatment of Headache
• Cardiac Applications of Positron Emission Tomography Scanning
• Chromoendoscopy as an Adjunct to Colonoscopy
• Cochlear Implant
• Cognitive Rehabilitation
• Confocal Laser Endomicroscopy
• Cryosurgical Ablation of Miscellaneous Solid Tumors Other Than Liver, Prostate, or Dermatologic Tumors
• Diabetes Prevention Program
• Endoscopic Radiofrequency Ablation or Cryoablation for Barrett Esophagus
• Endovascular Stent Grafts for Abdominal Aortic Aneurysms
• Esophageal pH Monitoring
• Fecal Microbiota Transplantation
• Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis
• Functional Neuromuscular Electrical Stimulation
• Gene Expression Profiling and Protein Biomarkers for Prostate Cancer Management
• Genetic and Protein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer
• Genetic Testing for Hereditary Breast/Ovarian Cancer Syndrome (BRCA1 or BRCA2)
• Genetic Testing for Statin-Induced Myopathy
• Genetic Testing for the Diagnosis of Inherited Peripheral Neuropathies
• Hematopoietic Cell Transplantation for Acute Lymphoblastic Leukemia
• Hematopoietic Cell Transplantation for Acute Myeloid Leukemia
• Hematopoietic Cell Transplantation for Autoimmune Diseases
• Hematopoietic Cell Transplantation for Central Nervous System Embryonal Tumors and Ependymoma
• Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
• Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia
• Hematopoietic Cell Transplantation for Epithelial Ovarian Cancer
• Hematopoietic Cell Transplantation for Hodgkin Lymphoma
• Hematopoietic Cell Transplantation for Miscellaneous Solid Tumors in Adults
• Hematopoietic Cell Transplantation for Non-Hodgkin Lymphomas
• Hematopoietic Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS Syndrome
• Hematopoietic Cell Transplantation for Primary Amyloidosis
• Hematopoietic Cell Transplantation for Solid Tumors of Childhood
• Hematopoietic Cell Transplantation For Waldenström Macroglobulinemia
• Hematopoietic Cell Transplantation in the Treatment of Germ Cell Tumors
• Human Leukocyte Antigen Testing for Celiac Disease
• Identification of Microorganisms Using Nucleic Acid Probes
• Implantable Bone-Conduction and Bone-Anchored Hearing Aids
• Ingestible pH and Pressure Capsule
• Intravenous Anesthetics for the Treatment of Chronic Pain
• Intravenous Antibiotic Therapy and Associated Diagnostic Testing for Lyme Disease
• Lysis of Epidural Adhesions
• Magnetic Esophageal Sphincter Augmentation to Treat Gastroesophageal Reflux Disease
• Measurement of Serum Antibodies to Infliximab and Adalimumab
• Microwave and Locoregional Laser Tumor Ablation
• Monitored Anesthesia Care
• Navigated Transcranial Magnetic Stimulation
• Neural Therapy
• Noninvasive Techniques for the Evaluation and Monitoring of Patients With Chronic Liver Disease
• Percutaneous Electrical Nerve Stimulation and Percutaneous Neuromodulation Therapy
• Peroral Endoscopic Myotomy for Treatment of Esophageal Achalasia
• Plugs for Anal Fistula Repair
• Prolotherapy
• Proteomic Testing for Targeted Therapy in Non-Small-Cell Lung Cancer
• Total Artificial Hearts And Implantable Ventricular Assist Devices
• Transanal Endoscopic Microsurgery
• Transanal Radiofrequency Treatment of Fecal Incontinence
• Transcutaneous Electrical Nerve Stimulation
• Wireless Capsule Endoscopy to Diagnose Disorders of the Small Bowel, Esophagus, and Colon


Click here to view the Blue Shield California 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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