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Blue Shield California October 2017 Medical Policy Updates

Click here to view the Blue Shield California October 2017 Medical Policy Updates »


New and Updated Policies
Effective October 1, 2017 

  • Acute and Maintenance Tocolysis
  • Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses
  • Allogeneic Hematopoietic Stem-Cell Transplantation for Genetic Diseases and Acquired Anemias
  • Allogeneic Pancreas Transplant
  • Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer
  • Automated Point-of-Care Nerve Conduction Tests
  • Bariatric Surgery
  • Biofeedback for Miscellaneous Indications
  • Chromosomal Microarray Testing for the Evaluation of Pregnancy Loss
  • Circulating Tumor DNA and Circulating Tumor Cells for Cancer Management (Liquid Biopsy)
  • Composite Tissue Allotransplantation of the Hand and Face
  • Cryosurgical Ablation of Miscellaneous Solid Tumors Other Than Liver, Prostate, or Dermatologic Tumors
  • Diagnosis and Medical Management of Obstructive Sleep Apnea Syndrome
  • Endometrial Ablation
  • Fecal Microbiota Transplantation 
  • Functional Neuromuscular Electrical Stimulation
  • Genetic Testing for Developmental Delay/Intellectual Disability, Autism Spectrum Disorder, and Congenital Anomalies
  • Hip Resurfacing
  • Hysterectomy Surgery for Benign Conditions
  • In Vitro Chemoresistance and Chemosensitivity Assays
  • Ingestible pH and Pressure Capsule
  • Injectable Bulking Agents for the Treatment of Urinary and Fecal Incontinence
  • Interventions for Progressive Scoliosis
  • Intracavitary Balloon Catheter Brain Brachytherapy for Malignant Gliomas or Metastasis to the Brain
  • Islet Transplantation
  • Isolated Small Bowel Transplant
  • Knee Braces
  • Laparoscopic and Percutaneous Techniques for the Myolysis of Uterine Fibroids
  • Lung and Lobar Lung Transplant
  • Magnetic Esophageal Sphincter Augmentation to Treat Gastroesophageal Reflux Disease
  • Magnetic Resonance Imaging‒Targeted Biopsy of the Prostate
  • Manipulation Under Anesthesia
  • Multigene Expression Assay for Predicting Recurrence in Colon Cancer
  • Noninvasive Prenatal Screening for Fetal Aneuploidies and Microdeletions Using Cell-Free Fetal DNA
  • Occlusion of Uterine Arteries Using Transcatheter Embolization
  • Oncologic Applications of Photodynamic Therapy, Including Barrett Esophagus
  • Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome
  • Patient-Specific Cutting Guides and Custom Knee Implants
  • Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence
  • Percutaneous Balloon Kyphoplasty, Radiofrequency Kyphoplasty, and Mechanical Vertebral Augmentation
  • Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux
  • Peroral Endoscopic Myotomy for Treatment of Esophageal Achalasia
  • Power Wheelchairs and Power Operated Vehicles for Permanent Use
  • Progenitor Cell Therapy for the Treatment of Damaged Myocardium due to Ischemia
  • Prostatic Urethral Lift
  • Regional Sympathetic Blocks
  • Reproductive Techniques
  • Small Bowel/Liver and Multivisceral Transplant
  • Subtalar Arthroereisis
  • Total Artificial Hearts and Implantable Ventricular Assist Devices
  • Transanal Endoscopic Microsurgery
  • Transcutaneous Electrical Nerve Stimulation
  • Vertical Expandable Prosthetic Titanium Rib
  • Whole Gland Cryoablation of Prostate Cancer


Click here to view the Blue Shield California October 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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