Highmark BCBS Medical Policy Updates – October 2023

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

October 2023 Highmark BCBS Medical Policy Updates:

• Ambulatory Blood Pressure Monitoring
• Autonomic Nervous System Function Testing
• Bendamustine (Treanda, Bendeka, Belrapzo)
• Beremagene geperpavec-svdt (Vyjuvek)
• Blinatumomab (Blincyto)
• Bone Mineral Density Studies
• Bortezomib (Velcade)
• Braces and Supports
• Brexanolone (Zulresso)
• Calcitonin Gene-Related Peptide (CGRP) Inhibitors
• Cardiac Monitors
• Cardiac Rehabilitation Programs, Phase II Outpatient
• Chemodenervation – Botulinum Toxin
• Cognitive Rehabilitation
• Coronary Revascularization
• Cranial Orthosis for Plagiocephaly
• Daratumumab (Darzalex) and Daratumumab and Hyaluronidase-fihj (Darzalex Faspro)
• Deep Brain Stimulation
• Devices Used for the Treatment of Obstructive Sleep Apnea in Adults
• Diagnosis and Treatment of Obstructive Sleep Apnea in Adults
• Durable Medical Equipment
• Electrical Nerve Stimulation
• Electroencephalogram
• Electroretinography
• Elotuzumab (Empliciti)
• Enteral Nutrition
• Enzyme Replacement Therapies
• Eptinezumab-jjmr (Vyepti)
• Evinacumab-dgnb (Evkeeza)
• Experimental/Investigational Services
• Fulvestrant (Faslodex)
• Heart Transplant
• Heart/Lung Transplant
• Hematopoietic Cell Transplantation: Non-Cancer Diseases
• Hemophilia Treatment Clotting Factors/Coagulant Blood Products
• Hepatobiliary System Imaging
• High Frequency Chest Wall Oscillation Devices
• Immune Globulin Therapy
• Impedance Cardiography in Hypertension
• Implantable Hormone Replacement Pellets
• Infliximab and Infliximab Biosimilars
• Intraoperative Neurophysiologic Monitoring (Sensory-Evoked Potentials, Motor-Evoked Potentials, EEG Monitoring)
• Irinotecan (Camptosar)
• Ixabepilone (Ixempra)
• Liver Transplant
• Lower Limb Prostheses
• Lung and Lobar Lung Transplant
• Manipulation Under Anesthesia
• Medical Nutrition Management Services (MNT)
• Naltrexone for Treatment of Alcohol and Opioid Dependence
• Nebulizers
• Non-spinal Bone Growth Stimulation
• Omalizumab (Xolair)
• Outpatient Pulmonary Rehabilitation
• Panitumumab (Vectibix)
• Pertuzumab (Perjeta)
• Pheresis Therapy
• Prescription Digital Therapeutics
• Repository Corticotropin Intramuscular Injection (Acthar Gel)
• Respiratory Assist Devices
• Rituximab (Rituxan), Rituximab Biosimilars, and Rituximab and Hyaluronidase Human (Rituxan Hycela)
• Small Bowel, Small Bowel/Liver and Multivisceral Transplant
• Subtalar Arthroereisis
• Surgery for Groin pain in Athletes
• Teclistamab-cqyv (Tecvayli)
• Tofersen (Qalsody)
• Treatment of Benign or Premalignant Skin Conditions
• Tumor Markers
• Ultrasound Osteogenesis Stimulator
• Ustekinumab (Stelara)
• Vision Therapy (Orthoptics and Pleoptics)
• Wearable Cardioverter-Defibrillator
• Wheelchairs (WC) and Options/Accessories
• Wireless Capsule Endoscopy as a Diagnostic Technique in Disorders of the Small Bowel, Esophagus, and Colon
• Ziv-aflibercept (Zaltrap)

Click here to the view the Highmark BCBS 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.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on medical Insurance decisions in real-time. When changes occur, instant email alerts are delivered to your inbox. Clients have access to detailed coverage reports and medical policies through the interactive Policy Alerts Dashboard portal. Save time each month and keep focused on important Payer medical policy reviews and coverage decisions affecting your business!

Policy Alerts takes a client-focused hands-on approach and is constantly working to provide our customers with helpful insights and actionable analytics. We understand what our clients need and are dedicated to providing timely, accurate, and always up-to-date reports.

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.