Independence Blue Cross Medical Policy Updates – June 2021

Click here to view the Independence Blue Cross Medical Policy Updates »

 June 2021 Independence Blue Cross Medical Policy Updates:

• Acute Care Facility Inpatient Transfers
• Air Ambulance Services
• Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma
• Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma
• Autonomic Nervous System Testing
• BCR-ABL Testing for Monitoring of Individuals with Chronic Myelogenous Leukemia or Acute Myelogenous Leukemia, who are Receiving Imatinib Mesylate (Gleevec®) Therapy
• Bioimpedence for the Detection of Lymphedema
• Blinatumomab (Blincyto®)
• Bone Mineral Density (BMD) Testing
• Cataract Surgery
• Cataract Surgery
• Chiropractic Spinal and Extraspinal Manipulation Therapy
• Complete Decongestive Therapy (CDT)
• Cosmetic Procedures
• Coverage of Anticancer Prescription Oral and Injectable Drugs and Biologics and Supportive Agents
• Daratumumab (Darzalex®), Daratumumab, and Hyaluronidase-fihj (Darzalex Faspro®)
• Endometrial Ablation
• Enzyme Replacement for the Treatment of Gaucher’s Disease
• Epidermal Growth Factor (EGFR) Mutation Analysis for individuals with non-small cell lung cancer
• Equipment, Supplies, and Pharmaceuticals for the Treatment of Diabetes
• Equipment, Supplies, and Pharmaceuticals for the Treatment of Diabetes
• Equipment, Supplies, and Pharmaceuticals for the Treatment of Diabetes
• Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
• Fecal Microbiota Transplantation (FMT)
• Gastric Electrical Stimulation (Enterra™), Gastric Pacing
• Genetic Testing for Inherited Breast Cancer 1 (BRCA1) and Breast Cancer 2 (BRCA2) Mutations
• Genetic Testing for Inherited Breast Cancer 1 (BRCA1) and Breast Cancer 2 (BRCA2) Mutations
• Hair Transplants and Cranial Prostheses (Wigs)
• Hair Transplants and Cranial Prostheses (Wigs)
• Home-Based Sleep Studies
• Implantation of Intrastromal Corneal Ring Segments (ICRS)
• Injectable Dermal Fillers
• Insulin Pumps and Long-Term Interstitial Continuous Glucose Monitoring Systems
• Insulin Pumps and Long-Term Interstitial Continuous Glucose Monitoring Systems
• Insulin Pumps and Long-Term Interstitial Continuous Glucose Monitoring Systems
• KRAS mutation analylsis to predict treatment response to elotinib (Tarceva®) in non-small cell lung cancer (NSCLC)
• Laboratory-Based Vestibular Function Testing
• Low-level Laser Therapy (LLLT)
• Lutathera® (Lutetium Lu 177 Dotatate)
• Lysis of Epidural Adhesions
• Magnetic Resonance Imaging (MRI)-Guided Focused Ultrasound Ablation
• Medical and Surgical Treatment of Temporomandibular Joint Disorder
• Mentoplasty or Genioplasty
• Migraine Deactivation Surgery
• Modifier 57: Decision for Surgery
• Modifier 66: Surgical Team
• Modifier 66: Surgical Team
• Modifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
• Modifier 77: Repeat Procedure or Service by Another Physician or Other Qualified Health Care Professional
• Neuromuscular Electrical Stimulators (NMES) and Functional Electrical Stimulators (FES)
• Neuropsychological Testing for Neurologically Based Conditions
• Neuropsychological Testing for Neurologically Based Conditions
• Nucleoplasty
• Ostomy Supplies
• Ostomy Supplies
• Otoplasty or Non-Surgical External Ear Molding
• Ovarian and Internal Iliac Vein Embolization as Treatment for Pelvic Congestion Syndrome
• Patient Lifts
• Percutaneous Discectomy
• Pharmacogenetic Testing to Determine Drug Sensitivity
• Pharmacogenetic Testing to Determine Drug Sensitivity
• Pharmacogenetic Testing to Determine Drug Sensitivity
• Pharmacogenetic Testing to Determine Drug Sensitivity
• Pharmacogenetic Testing to Determine Drug Sensitivity
• Pharmacogenetic Testing to Determine Drug Sensitivity
• Pharmacogenetics and Metabolite Monitoring for Using Azathioprine (AZA)/6-Mercaptopurine (6-MP) Therapy
• Photodynamic Therapy (PDT) Using Levulan® Kerastick® or Ameluz® (Aminolevulinic Acid HCl [ALA])
• Photodynamic Therapy (PDT) Using Levulan® Kerastick® or Ameluz® (Aminolevulinic Acid HCl [ALA])
• Photodynamic Therapy (PDT) Using Verteporfin (Visudyne®)
• Polatuzumab Vedotin-Piiq (Polivy®)
• Preimplantation Genetic Testing
• Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
• Procedures for the Treatment of Gastroesophageal Reflux Disease (GERD)
• Prophylactic Mastectomy, Oophorectomy/Salpingo-Oophorectomy, and Hysterectomy
• Radium Ra 223 dichloride (Xofigo®) Injection (Independence Administrators)
• Reduction Mammoplasty
• Refractive Keratoplasty
• Sacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for the Control of Incontinence
• Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
• Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
• Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
• Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
• Self-Administered Drugs
• Self-Administered Drugs
• Short-term Interstitial Continuous Glucose Monitoring Systems (CGMSs)
• Short-term Interstitial Continuous Glucose Monitoring Systems (CGMSs)
• Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies
• Solid Organ Transplantation and Procurement Cost of Organs and Tissues
• Stem-Cell Therapy for Orthopedic Applications and Autologous Platelet-Derived Growth Factors (PDGFs)/Platelet-Rich Plasmas (PRPs) for Acute or Chronic Wound Healing and Other Miscellaneous Conditions
• Subcutaneous Implantable Cardioverter Defibrillator (S-ICD) for Treating Life-threatening Ventricular Tachyarrhythmia
• Surgery for Gynecomastia
• Surgical Correction of Strabismus
• Surgical Correction of Strabismus
• Surgical Treatments of Athletic Pubalgia
• Therapeutic Drug Monitoring for Antidepressants, Antipsychotics, or Antiepileptics
• Transcranial Magnetic Stimulation (TMS)
• Treatment of Medical and Surgical Complications
• Trigger Point Injections
• Uterine Artery Embolization
• Vagus Nerve Stimulation (VNS)
• Wireless Capsule Endoscopy (WCE) as a Diagnostic Technique in Disorders of the Small Bowel, Esophagus, and Colon
• Wireless Capsule Endoscopy (WCE) as a Diagnostic Technique in Disorders of the Small Bowel, Esophagus, and Colon

Click here to view the Independence Blue Cross Medical Policy Updates »

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