Highmark BCBS Medical Policy Updates – May 2018

Click here to the view the Highmark Blue Cross Blue Shield Medical Policy Updates »

May 2018 Medical Policy Updates:

• Abatacept (Orencia)
• Agalsidase beta (Fabrazyme)
• Alglucosidase alfa (Lumizyme)
• Alpha1-Proteinase Inhibitor Infusions
• Anthrax Immunization and Treatment
• Assistant Surgery Eligibility Criteria
• Assisted Reproductive Technology
• Belimumab (Benlysta)
• Biofeedback
• Brentuximab Vedotin (Adcetris®)
• Cetuximab (Erbitux)
• Corneal Collagen Cross-Linking and Collagen Crosslinks
• Co-Surgery
• Daratumumab (Darzalex™)
• Dental Services
• Diagnosis and Treatment of Male Sexual Dysfunction
• Digital Imaging Systems for the Detection and Evaluation of Diabetic Retinopathy
• Eculizumab (Soliris)
• Electric Breast Pumps
• Electrical Nerve Stimulation
• Electroencephalogram (EEG) Technologies
• Elosulfase alfa (Vimizim)
• Fulvestrant (Faslodex)
• GI Effects Comprehensive Stool Profile
• Golimumab (Simponi, Simponi Aria)
• Idursulfase (Elaprase)
• Immune Globulin Therapy
• In Vitro Allergy Testing
• Infliximab
• Mammography
• Medical Policy
• Miscellaneous Services
• Monoclonal Antibodies for the Treatment of Eosinophilic Conditions
• Pertuzumab (Perjeta)
• Physician Certification and Recertification of Home Health Services
• Programmed Death Receptor (PD-1)/ Programmed Death-Ligand (PD-L1) Blocking Antibodies
• Prolonged Detention or Critical Care
• Prolotherapy
• Provider Overhead Expenses
• Routine Neonatal Circumcision/Slitting of Prepuce
• Sexually Transmitted Infections: Molecular
• Stereotactically Guided Core-needle Breast Biopsy
• Subtalar Arthroereisis
• Team Surgery
• Tocilizumab (Actemra)
• Transcranial Magnetic Stimulation (TMS)
• Treatment of Abnormal Uterine Bleeding and Fibroids
• Treatment of Gaucher Disease
• Treatment of Hereditary Angioedema (HAE)
• Ustekinumab (Stelara®)
• Vedolizumab (Entyvio®)
• Ventilatory Assistance (Respirator Care)
• Zoledronic Acid (Reclast®, Zometa®)

Click here to the view the Highmark Blue Cross Blue Shield Medical Policy Updates »

Policy Alerts monitors Commercial and Medicare medical policies for changes. While medical Insurance carriers typically update medical policies annually, there are many reasons why they might review or update a policy. When reviews occur out of cycle they often go unnoticed. Policy Alerts keeps you updated when Payers make coverage changes to medical policies affecting your business.

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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. All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or endorsement by them. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.