Chat with us, powered by LiveChat
skip to Main Content

Florida Blue Cross Blue Shield July 2017 Medical Policy Updates

Florida Blue Cross Blue Shield July 2017 Medical Policy Updates
Florida BCBS Blue Cross Blue Shield Medical Policy Updates

Florida Blue Cross Blue Shield posts July 2017 Medical Policy Updates:

Click here to view the Florida Blue Cross Blue Shield July 2017 Medical Policy Updates »

New MCGs:

Revised MCGs:

1. Apheresis, Plasmapheresis and Plasma Exchange – Revision: Revised description section, coverage for low-density lipoprotein (LDL) apheresis, and definitions section. Updated references.
2. Balloon Ostial Dilation (Balloon Sinuplasty) and Implantable Devices – Guideline reviewed. Revised position statement (added long-term and health).
3. Bendamustine HCl (Bendeka®, Treanda®) Injection – Review and revision to guideline consisting of updating and reformatting the position statement and updating the precautions and references.
4. Bevacizumab (Avastin®) Injection – Review and revision to guideline; consisting of revising position statement, description, dosing, coding and references.
5. Bortezomib (Velcade®) Injection – Review and revision to guidelines consisting of updating the description section, position statement, and references.
6. Botulinum Toxins – Revision to guideline consisting of clarifying the position statement and updating the dosage/administration section.
7. Carfilzomib (Kyprolis™) Injection – Review and revision to guidelines consisting of updating the description section, position statement, precautions, and references.
8. Ceritinib (Zykadia™) Capsules – Revision to guideline; updated position statement with new NCCN recommendations.
9. Daratumumab (Darzalex®) Injection – Review and revision to guidelines consisting of updating the description section, position statement, and references.
10. Ductal Lavage and Suction Collection Systems – Revision; Position statement, description section, and references updated.
11. Elotuzumab (EmplicitiTM) Injection – Review and revision to guidelines consisting of updating the description section, position statement, dosage/administration section, and references.
12. Endovascular Stent Grafts for Abdominal Aortic Aneurysms – Review; position statements maintained; title, description, and references updated.
13. Evoked Potentials, Intraoperative Neurophysiologic Monitoring, and Quantitative Electroencephalography (QEEG) – Revision; Intraoperative monitoring position statements and references updated.
14. Extracranial Carotid Angioplasty Stenting – Revision; position statements and references updated; formatting changes.
15. Implantable Cardioverter Defibrillators (ICD) – Review; position statements maintained and references updated; formatting changes.
16. Infliximab Products [infliximab (Remicade®), infliximab-dyyb (Inflectra®), and infliximab-abda (Renflexis®)] – Revision to guideline consisting of updating the position statement for infliximab-dyyb (Inflectra) and addition of infliximab-abda (Renflexis). MCG title renamed to “Infliximab Products.”
17. Intravenous Enzyme Replacement Therapy For Gaucher Disease – Review and revision to guideline; consisting of updating description and position statement.
18. Ivacaftor (Kalydeco TM) Oral – Revised position statement to include new mutations per updated FDA indication.
19. Ixazomib (Ninlaro®) Capsule – Review and revision to guidelines consisting of updating the description section, position statement, and references.
20. Melphalan HCl, Captisol-Enabled (Evomela®) IV Infusion – Review and revision to guidelines consisting of updating the position statement to only include use as a high-dose conditioning treatment prior to stem cell transplantation for treatment of MM. The NCCN no longer recommends melphalan as part of any MM treatment regimen.
21. Nab-Paclitaxel Injection (Abraxane) – Revision to guideline; consisting of updating position statement, description, dosing, coding and references.
22. Oral Therapy for Gaucher Disease – Review and revision to guideline; consisting of updating position statement and description.
23. Orthognathic Surgery – Scheduled review. Maintained position statement and updated references. Reformatted guideline.
24. Panobinostat (Farydak) Capsule – Review and revision to guideline consisting of updating the description section, position statement, precautions, and references.
25. Pembrolizumab (Keytruda®) Injection – Review and revision to guideline; consisting of updating position statement, description, dosing, coding and references.
26. Pirfenidone (Esbriet) Oral Capsule – Revision to position statement and dosage/administration; added new FDA approved dosage form (tablets).
27. Pomalidomide (Pomalyst®) Capsule – Review and revision to guidelines consisting of updating the description section, position statement, and references.
28. Pulmonary Hypertension Drug Therapy – Review and revision to guideline; consisting of position statement.
29. Regorafenib (Stivarga®) Tablets – Review and revision to guideline; consisting of updating position statement, description, dosing, coding and references.
30. Ribociclib (Kisqali®) – Revision to guideline; Updated position statement with new Kisqali Femara Co-Pack formulation.
31. Signal Averaged Electrocardiography (SAECG) – Revision; investigatioinal status maintained, description, position statement, and references updated.
32. Tetrabenazine (Xenazine) and Deutetrabenazine (Austedo) – Review and revision to guideline; consisting of revising position statement.
33. Tocilizumab (Actemra®) Injection – Revision to guideline consisting of updating the position statement, dosage/administration section, coding/billing, and references to include a new FDA-approved indication of giant cell arteritis (GCA).
34. Transcatheter Mitral Valve Repair (TMVR) – Annual review; position statements maintained and references updated.
35. Trastuzumab (Herceptin®) Injection – Revision to guideline; updated dosage and administration with new vial size.
36. Treatments for Varicose Veins/Venous Insufficiency – Revision; position statement section updated to incude CHIVA method; references updated.
37. Viscocanalostomy and Canaloplasty – Scheduled review. Maintained Position Statement section. Updated references. Reformatted guideleine.

 

Click here to view the Florida Blue Cross Blue Shield July 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.

Back To Top