Click here to view the Blue Cross Blue Shield BCBS Massachusetts Medical Policy Updates »…
Capital Blue Cross Medical Policy Updates – February 2023
Click here to view the Capital Blue Cross Medical Policy Updates »
February 2023 Capital Blue Cross Medical Policy Updates:
- Abraxane® (paclitaxel protein-bound particles) (Intravenous)
- Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry
- Amvuttra (vutrisiran)
- Balloon Dilation for the Eustachian Tube
- Bio-Engineered Skin and Soft Tissue Substitutes
- Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting
- Cerezyme® (imiglucerase) (Intravenous)
- Colony Stimulating Factors – Pegfilgrastim
- Colony Stimulating Factors – Pegfilgrastim: Neulasta®; Fulphila®; Udenyca®; Ziextenzo™; Nyvepria™ (Subcutaneous)
- Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bone
- Cryosurgical Ablation of Primary or Metastatic Liver Tumors
- Cytochrome P450 Genotype Guided Treatment Strategy (Formerly Cytochrome P450 Genotyping)
- Darzalex® (daratumumab)
- Darzalex® (daratumumab) (Intravenous)
- Donor Lymphocyte Infusion for Hematologic Malignancies
- Donor Lymphocyte Infusion for Hematologic Malignancies Treated with an Allogeneic HCT
- Dynamic Spinal Visualization And Vertebral Motion Analysis
- Elelyso™ (taliglucerase alfa) (Intravenous)
- Enhertu® (fam-trastuzumab deruxtecan-nx (Intravenous)
- Esketamine (Spravato)
- Genetic and Protein Biomarkers for the Management, Diagnosis and Cancer Risk Assessment of Prostate Cancer
- Genetic Testing for Developmental Delay/Intellectual Disability, Autism Spectrum Disorder, and Congenital Anomalies
- Genetic Testing for Mitochondrial Disorders
- Germline Genetic Testing for Hereditary Diffuse Gastric Cancer (CDH1,CTNNA1)
- Heart Transplant
- Heart Transplant
- Hyperthermic Intraperitoneal Chemotherapy for Select Intra-Abdominal and Pelvic Malignancies
- Imfinzi® (durvalumab) (Intravenous)
- Infliximab: Remicade®, Inflectra™, Renflexis™, Avsola™, Infliximab
- Infliximab: Remicade®; Inflectra™; Renflexis™; Avsola™; Infliximab* (Intravenous)
- Intravitreal and Punctum Corticosteroid Implants
- Invasive Prenatal (Fetal) Diagnostic Testing
- Invasive Prenatal (Fetal) Diagnostic Testing
- Isolated Small Bowel Transplant and Small Bowel/Liver and Multivisceral Transplant
- Jemperli® (dostarlimab-gxly) (Intravenous)
- Jemperli® (dostarlimab‐gxly) Preauthorization Request (Preauthorization is not a guarantee of payment)
- Keytruda® (pembrolizumab) (Intravenous)
- Keytruda® (pembrolizumab) Preauthorization Request (Preauthorization is not a guarantee of payment)
- KIF6 Genotyping for Predicting Cardiovascular Risk and/or Effectiveness of Statin Therapy
- Kyprolis® (carfilzomib) (Intravenous)
- Myocardial Sympathetic Innervation Imaging in Patients with Heart Failure
- Olinvyk (oliceridine)
- Onpattro (patisiran lipid complex) (Intravenous)
- Opdivo® (nivolumab) (Intravenous)
- Opdivo® (nivolumab) Intravenous Preauthorization Request (Preauthorization is not a guarantee of payment)
- Palivizumab (Synagis®) Criteria for Respiratory Syncytial Virus (RSV) Infection
- Paraspinal Surface Electromyography to Evaluate and Monitor Back Pain
- Physical Medicine and Specialized Physical Medicine Treatments (Outpatient)
- Polysomnography for Non-Respiratory Sleep Disorders
- Positron Emission Mammography
- Prosthetics and Accessories
- Ranibizumab: Lucentis®; Byooviz™ (Intravitreal)
- Reconstructive Breast SurgeryManagement of Breast Implants
- Retinal Telescreening for Diabetic Retinopathy and Intraocular Photography
- Retinal Telescreening for Diabetic Retinopathy and Intraocular Photography
- Rituximab: Rituxan®, Truxima®, Ruxience®, Riabni™ (Intravenous)
- Skyrizi® (risankizumab-rzaa)
- Skysona® (elivaldogene autotemcel)
- Soliris® (eculizumab) (Intravenous)
- Stelara ® (ustekinumab)
- Stelara® (ustekinumab) (Intravenous/Subcutaneous)
- Suprachoroidal Delivery of Pharmacologic Agents
- Suprachoroidal Delivery of Pharmacologic Agents
- Tecentriq® (atezolizumab) (Intravenous)
- Tecentriq® (atezolizumab) Intravenous Preauthorization Request (Preauthorization is not a guarantee of payment)
- Therapeutic Radiopharmaceuticals in Oncology
- Trastuzumab: Herceptin®; Ogivri®; Kanjinti™ ; Trazimera ;™Herzuma®; Ontruzant®
- Trastuzumab: Herceptin®; Ogivri®; Kanjinti™; Trazimera™; Herzuma®; Ontruzant® (Intravenous)
- Treatment of Varicose Veins/Venous Insufficiency
- Ultomiris® (ravulizumab-cwvz) (Intravenous)
- Use of Common Genetic Variants (Single Nucleotide Polymorphisms) to Predict Risk of Non-Familial Breast Cancer
- Vagus Nerve Blocking Therapy for Treatment of Obesity
- VPRIV® (velaglucerase alfa) (Intravenous)
- Wound and Burn Care and Specialized Treatment Centers
- Yervoy® (ipilimumab) (Intravenous)
- Yervoy® (ipilimumab) Intravenous Preauthorization Request (Preauthorization is not a guarantee of payment)
Click here to view the Capital Blue Cross Medical Policy Updates »
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