Health Care Service Corporation September 2017 Medical Policy Updates

Health Care Service Corporation (HCSC – BCBS IL, TX, OK, NM, MT) posts September 2017 Medical Policy Updates:

Health Care Service Corporation September 2017 Medical Policy Updates »

The following Medical Policies are Pending;

Policy Title

Policy Number

Release Date

Acne Management	THE801.028	10-15-2017
Acoustic Respiratory Management (ARM)	MED201.037	10-15-2017
Airway Clearance Devices	DME101.027	10-15-2017
Alemtuzumab (Lemtrada)	RX501.077	10-15-2017
Back School	THE803.024	10-15-2017
Bioimpedance Devices for Detection of Lymphedema	MED201.036	10-15-2017
Cardiac Contractility Modulation (CCM) Device	MED202.068	10-15-2017
Cervical and Thoracic Spinal Fusion	SUR712.041	10-15-2017
Composite Tissue Allotransplantation of the Hand and Face	SUR703.052	10-15-2017
Computerized 2-lead Resting Electrocardiogram Analysis for the Diagnosis of Coronary Artery Disease	MED202.063	10-15-2017
Cryosurgical Ablation of Miscellaneous Solid Tumors Other Than Liver, Prostate, or Dermatologic Tumors	SUR701.018	10-15-2017
Cryosurgical Ablation of Primary or Metastatic Liver Tumors	SUR701.032	10-15-2017
Dynamic Cardiomyoplasty	SUR707.005	10-15-2017
Electrocardiographic Body Surface Mapping	MED202.061	10-15-2017
Electromagnetic Navigation Bronchoscopy (ENB)	SUR706.013	10-15-2017
Endobronchial Valves	SUR706.015	10-15-2017
Endovascular Grafts (Endoprostheses) for Abdominal Aortic Aneurysms	MED202.051	10-15-2017
Extracorporeal Shock Wave Treatment for Musculoskeletal Indications and Soft Tissue Injuries	SUR705.018	10-15-2017
Extracranial Carotid Angioplasty or Stenting	SUR701.028	10-15-2017
Facet Joint and Sacroiliac Joint Denervation	SUR702.017	10-15-2017
Functional Neuromuscular Electrical Stimulation (FNMES)	MED201.033	10-15-2017
Home Spirometry	DME101.040	10-15-2017
Inhaled Nitric Oxide	THE801.038	10-15-2017
Interferential Current Stimulation	MED201.041	10-15-2017
Intracellular Micronutrient Analysis	MED207.088	10-15-2017
Intravitreal Angiogenesis Inhibitors for Choroidal Vascular Conditions	OTH903.020	10-15-2017
Intravitreal Corticosteroid Implants	OTH903.024	01-01-2018
Isolated Facet Joint Fusion	SUR712.032	10-15-2017
Isolated Limb Perfusion/Infusion for Malignant Melanoma	SUR701.010	01-01-2018
Lower Limb Prosthetics, Including Microprocessor Prosthetics	DME104.012	10-15-2017
Melanoma Vaccines	MED203.010	10-15-2017
Microwave Thermotherapy for Primary Breast Cancer	SUR701.020	10-15-2017
Navigated Transcranial Magnetic Stimulation (nTMS)	MED205.037	10-15-2017
Non-Invasive Measurement of Central Blood Pressure (cBP)	MED202.070	10-15-2017
Optical Coherence Tomography of the Breast	RAD601.053	10-15-2017
Orthopedic Applications of Stem-Cell Therapy	SUR703.051	10-15-2017
Patient-Specific Cutting Guides and Custom Knee Implants	SUR705.037	10-15-2017
Prostatic Urethral Lift (PUL) for the treatment of Benign Prostatic Hyperplasia (BPH)	SUR710.023	10-15-2017
Quantitative Sensory Testing	MED205.030	10-15-2017
Radiostereometric Analysis for Assessment of Orthopedic Implant Position	RAD601.054	10-15-2017
Reslizumab (CINQAIR)	RX501.083	10-15-2017
Risk Stratification Tests for Determining Arrhythmias (Signal-Averaged Electrocardiography [SAECG] and Microvolt T-Wave Alternans [MTWA])	MED202.006	10-15-2017
Serum Holotranscobalamin (holo-TC) as a Marker of Vitamin B12 (Cobalamin) Status	MED207.138	10-15-2017
Sodium Phenylbutyrate	RX501.057	10-15-2017
Speech Generating Devices (SGD)	DME104.009	10-15-2017
Suprachoroidal Delivery of a Pharmacologic Agent	OTH903.035	10-15-2017
Surface Scanning Electromyography (EMG) (SEMG), Paraspinal Surface EMG, and Spinoscopy	MED205.006	10-15-2017
Transcatheter Mitral Valve Repair	SUR707.025	10-15-2017
Transcatheter Pulmonary Valve Implantation	SUR707.029	10-15-2017
Transciliary Fistulization for the Treatment of Glaucoma	SUR713.033	10-15-2017
Ultrasonographic Evaluation of Skin Lesions	RAD602.017	10-15-2017
Visual Evoked Potential Testing for Glaucoma	OTH903.033	10-15-2017
Xolair (Omalizumab)	RX501.058	10-15-2017

Health Care Service Corporation September 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.

Health Care Service Corporation (HCSC)