Geisinger Health Plan Medical Policy Updates – June 2021

Click here to view the Geisinger Health Plan Medical Policy Updates »

June 2021 Geisinger Medical Policy Updates:

• Aquatic Therapy
• Autism Spectrum Disorder – Evaluation and Medical Management
• Autologous Platelet-Derived Growth Factor
• Aveed testosterone undecanoate
• Blincyto blinatumomab
• Carotid Artery Stent
• Chelation Therapy
• Cinqair reslizumab
• CoCorneal Topography
• Contact Lenses
• Continuous Subcutaneous Glucose Monitor (CSGM)
• Corneal Pachymetry
• Cosentyx secukinumab vials
• Cresemba IV isavuconazonium sulfate
• Cystourethroscopy with Insertion of Urethral Stent
• Darzalex daratumumab
• Entyvio vedolizumab
• Eraxis anidulafungin
• Fecal Microbiota Transplantation
• Functional Anesthetic Discography
• Gene Expression Profiling for Breast Cancer Treatment
• Genetic Testing for BRCA1 or BRCA2 for Breast or Ovarian Cancer
• GliaSite Radiation Therapy
• Home Health Related to Hyperbilirubinemia
• Home Phlebotomy Program
• Home Uterine Activity Monitor
• Human Papillomavirus HPV DNA Testing
• Iluvien fluocinolone acetonide
• Injectable Antipsychotic Medications
• Intercostal Nerve Block
• Intrathecal Infusion Pump
• Keytruda pembrolizumab
• Lemtrada alemtuzumab
• Makena hydroxyprogesterone caproate
• Microvolt T-wave Alternans
• Mircera methoxy polyethylene glycolepoetin beta
• Nasal and Sinus Surgery
• Non-contact Low-frequency Ultrasound for Wound Management MIST Therapy
• Nucala mepolizumab
• Ocrevus ocrelizumab
• Opdivo nivolumab
• Osseointegrated Hearing Device eg Bone Anchored hearing Aid BAHA Hearing Device
• Photodynamic Therapy for Esophageal and Lung Cancer
• Phototherapy for the Treatment of Dermatological Conditions
• Polysomnography and Sleep Studies
• Progressive Stretch Devices
• Prolotherapy
• Prophylactic Mastectomy
• Prophylactic Oophorectomy
• Pulse Oximetry for Pediatric Home Use
• Radicava edaravone
• Remodulin IV treprostinil
• Ruconest C1 esterase inhibitor recombinant
• SiAria golimumab
• Somnoplasty Coblation Radiofrequency Ablation
• Sustol granisetron ER
• SyTherapy
• Transanal Radiofrequency Therapy for Fecal Incontinence Secca
• Transmyocardial Laser Revascularization
• Treatment of Dry Eye Syndrome
• Treatment of Vestibular Disorders
• Unituxin dinutuximab
• Varicose Vein Treatments
• Vision Therapy   Orthoptics
• Visual Field Testing
• VPRIV velaglucerase alfa
• Xolair omalizumab
• Zinplava bezlotoxumab

Click here to view the Geisinger Health Plan Medical Policy Updates »

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