Click here to view the United Healthcare (UHC) Medical Policy Updates » December 2024 United…
HCSC Pending Medical Policy Updates – June 2018
Click here to view the Health Care Service Corporation Pending Medical Policy Updates »
June 2018 Pending Medical Policies:
- Adcetris (brentuximab vedotin)
- Adipose-Derived Stem-Cells in Autologous Fat Grafting to the Breast
- Auditory Brainstem Implant
- Automated Percutaneous Discectomy and Percutaneous Endoscopic Discectomy
- Biofeedback as a Treatment of Urinary Incontinence
- Corneal Collagen Cross-Linking
- Deep Brain Stimulation (DBS)
- Elastography
- Electrical Impedance Scanning (EIS) of the Breast
- Electrical Stimulation for the Treatment of Arthritis
- Electrostimulation and Electromagnetic Therapy for the Treatment of Chronic Wounds
- Endothelial Keratoplasty
- Extracorporeal Shock Wave Therapy in the Treatment of Peyronies Disease
- FDA-Approved Drugs and Biologicals
- Facet Joint and Sacroiliac Joint Denervation
- Gastric Electrical Stimulation (GES)
- Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery
- Hematopoietic Stem-Cell Transplantation for Acquired Immunodeficiency Syndrome (AIDS)
- Hematopoietic Stem-Cell Transplantation for Acute Lymphoblastic Leukemia (ALL)
- Hematopoietic Stem-Cell Transplantation for Breast Cancer
- Hematopoietic Stem-Cell Transplantation for Malignant Astrocytomas and Gliomas
- Hematopoietic Stem-Cell Transplantation for Solid Tumors in Children
- Image-Guided Minimally Invasive Decompression for Spinal Stenosis
- Implanted Adjustable Continence Therapy
- In-Vivo Analysis of Colorectal Polyps
- Intracellular Micronutrient Analysis
- Intravitreal Corticosteroid Implants
- Keratoprosthesis
- Kyprolis (carfilzomib)
- Manipulation Under Anesthesia
- Mental Health Services
- Non-Surgical Spinal Decompression Traction Devices
- Nusinersen (Spinraza)
- Obinutuzumab (Gazyva)
- Ophthalmologic Techniques For Evaluating Glaucoma
- Orthognathic Surgery
- Patient-Specific Cutting Guides and Custom Knee Implants
- Peripheral Subcutaneous Field Stimulation
- Pulmonary Rehabilitation
- Pulse Oximeter for Home Use
- Rituxan (Rituximab)
- Semi-Implantable and Fully Implantable Middle Ear Hearing Aids
- Sexual Dysfunctions, Assessment and Treatment
- Sodium Phenylbutyrate
- Surgery for Groin Pain in Athletes
- Surgical Treatment of Gynecomastia
- Temporary Prostatic Stent
- Transcoronary Ablation of Septal Hypertrophy (TASH)
- Viscocanalostomy and Canaloplasty
- Work Hardening
Added 6/27/2018;
- Ambulance and Medical Transport Services
- Belinostat (Beleodaq)
- Biofeedback as a Treatment of Fecal Incontinence or Constipation
- Biofeedback for Miscellaneous Indications
- Chemical Peels
- Copanlisib (Aliqopa)
- Dynamic Posturography
- Endoscopic, Arthroscopic, Laparoscopic, and Thoracoscopic Surgery
- Hematopoietic Stem-Cell Transplantation for Central Nervous System Embryonal Tumors and Ependymoma
- Human Fibrinogen Concentrate (RiaSTAP and Fibryga)
- Human Growth Hormone (GH)
- Implantation of Intrastromal Corneal Ring Segments
- Melanoma Vaccines
- Physical Therapy (PT) and Occupational Therapy (OT) Services
- Powered Exoskeleton for Ambulation in Patients With Lower-Limb Disabilities
- Pulse-Echo Ultrasound Bone Density Measurement
- Radiofrequency Ablation (RFA) of Solid Tumors, Excluding Liver
- Stem-Cell Therapy for Peripheral Arterial Disease (PAD)
- Transpupillary Thermotherapy (TTT)
- Transtympanic Micropressure Applications as a Treatment of Meniere Disease
- Ultrasound Wound Therapy
- Whole Body Composition Analysis using Dual X-Ray Absorptiometry (DXA) or Bioelectrical Impedance Analysis (BIA)
Added 6/28/2018;
- Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions
- Autologous Chondrocyte Implantation (ACI) for Focal Articular Cartilage Lesions
- Biologic Response Modifiers (BRMs) for the Treatment of Rheumatoid Arthritis (RA) and Other Chronic Inflammatory Diseases
- Computer-Assisted Navigation for Orthopedic Procedures
- Computerized Wheeze Detection/Monitoring
- Continuous Passive Motion (CPM) Device
- Corneal Hysteresis
- Drug-Eluding Intracanalicular Punctal Plugs and Ocular Inserts
- Edaravone (Radicava)
- Eyelid Thermal Pulsation Therapy
- Functional Neuromuscular Electrical Stimulation (FNMES)
- Gastrointestinal (GI) Motility Measurement
- Hematopoietic Stem-Cell Transplantation for Chronic Myelogenous Leukemia (CML)
- Hematopoietic Stem-Cell Transplantation for Hodgkin Lymphoma (HL)
- Hematopoietic Stem-Cell Transplantation for Waldenström Macroglobulinemia
- Hip Resurfacing (HR)
- Hippotherapy
- Hormone Replacement Therapies (HRT) Using Implanted Pellets for Women and Delayed Puberty
- Inside the U.S. Food and Drug Administration (FDA)
- Interferon alfa-N3 (Alferon N Injection)
- Intravenous or Subcutaneous Histamine Therapy
- Knee Braces
- Levodopa-Carbidopa Enteral Suspension (e.g. Duopa) for The Treatment of Parkinson Disease.
- Mepolizumab (Nucala)
- Microwave Thermotherapy for Primary Breast Cancer
- Non-Invasive Measurement of Central Blood Pressure (cBP)
- Occipital Nerve Stimulation
- Onivyde (irinotecan liposome)
- Optical Coherence Tomography of the Anterior Eye Segment
- Optical Diagnostic Devices for Evaluating Skin Lesions Suspected of Malignancy
- Photocoagulation of Macular Drusen
- Phototherapeutic Keratectomy
- Plugs for Fistula Repair
- Refractive and Therapeutic Keratoplasty
- Reproductive Technologies or Techniques and Related Services
- Sacral Nerve Neuromodulation/Stimulation
- Sensory Integration Therapy and Auditory Integration Therapy
- Speech Generating Devices (SGD)
- Subtalar Arthroereisis (STA)
- Surface Electrical Stimulation
- Sustol (Granisetron) Extended Release Injection
- Topographic Brain Mapping (Quantitative Electroencephalography)
- Wheelchairs and Accessories
Click here to view the Health Care Service Corporation Pending Medical Policy Updates »
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