Chat with us, powered by LiveChat
skip to Main Content

BCBS Horizon Medical Policy Updates – December 2018

BCBS Horizon Medical Policy Updates – December 2018
BCBS Horizon NJ Medical Policy Updates

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

December 2018 Medical Policy Updates:

  • Abdominoplasty
  • Adult Abdomen Imaging Policy
  • Adult Spine Imaging Policy
  • Agalsidase Beta (Fabrazyme)
  • Allergen Immunotherapy
  • Allogeneic Pancreas Transplant
  • Applied Behavior Analysis in the Treatment of Autism Spectrum Disorders (ASD)
  • Autonomic Nervous System Testing
  • Axicabtagene Ciloleucel (Yescarta)
  • Belimumab (Benlysta)
  • Bendamustine hydrochloride (Treanda Bendeka)
  • Beta Amyloid Imaging with Positron Emission Tomography (PET) for Alzheimers Disease
  • Bioengineered Skin and Soft Tissue Substitutes
  • Biofeedback
  • Bone Mineral Density Studies and Vertebral Fracture Assessment With Densitometry
  • Bortezomib (Velcade)
  • Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting
  • Carfilzomib (Kyprolis)
  • Chiropractic Review Policy
  • Chromosomal Microarray Analysis for the Evaluation of Pregnancy Loss
  • Circulating Tumor DNA for Management of Non-Small-Cell-Lung Cancer (Liquid Biopsy)
  • Colorectal Cancer Screening
  • Computed Tomography (CT) Perfusion Imaging of the Brain
  • Continuous or Intermittent Monitoring of Glucose in the Interstitial Fluid
  • Definition of Investigational or Experimental Procedure
  • Donor Lymphocyte Infusion for Malignancies Treated with an Allogeneic Hematopoietic Stem-Cell Transplant
  • Drug Therapy for Hereditary Angioedema [Cinryze Berinert Haegarda (Human C1 Inhibitor) Kalbitor (Ecallantide) Firazyr (Icatibant) Ruconest (C1 Esterase Inhibitor [Recombinant])]
  • Dupilumab (Dupixent)
  • Eculizumab (Soliris)
  • Endobronchial Ultrasound for Diagnosis and Staging of Lung Cancer
  • Erythropoietin Therapy Epoetin Alfa Darbepoetin Alfa Pegylated (PEG)-epoetin Beta and Epoetin Alfa-epbx
  • Esophageal pH Monitoring
  • Expanded Molecular Panel Testing of Cancers to Identify Targeted Therapies
  • Fecal Microbiota Transplantation
  • Focal Treatments for Prostate Cancer
  • Foot Care Services
  • Fulvestrant (Faslodex)
  • Gaucher Disease Therapy
  • Gene Expression Profiling and Protein Biomarkers for Prostate Cancer Management
  • Genetic Cancer Susceptibility Panels Using Next Generation Sequencing
  • Genetic Testing for Lynch Syndrome and Other Inherited Colon Cancer Syndromes
  • Golimumab (Simponi Aria)
  • Heart Transplant
  • Hematopoietic Cell Transplantation for Plasma Cell Dyscrasias Including Multiple Myeloma and POEMS Syndrome
  • Ibalizumab-uiyk (Trogarzo)
  • Immune Globulin Subcutaneous (Vivaglobin Hizentra Gammagard Liquid Gamunex-C or Gammaked HyQvia and Cuvitru for Subcutaneous Administration)
  • Injectable Bulking Agents for the Treatment of Urinary Incontinence
  • Intravenous Immunoglobulin (IVIG) Therapy
  • Invasive Prenatal (Fetal) Diagnostic Testing
  • Islet Transplantation
  • Lemtrada (Alemtuzumab)
  • Liver Transplant and Combined Liver-Kidney Transplant
  • Meniscal Allografts and Other Meniscal Implants
  • Microwave Tumor Ablation
  • Molecular Analysis for Targeted Therapy for Non-Small-Cell Lung Cancer
  • Molecular Markers in Fine Needle Aspirates of the Thyroid
  • Molecular Testing for the Management of Pancreatic Cysts or Barrett Esophagus
  • Multigene Expression Assay for Predicting Recurrence in Colon Cancer
  • Myocardial Sympathetic Innervation Imaging in Patients with Heart Failure
  • Noninvasive Prenatal Screening for Fetal Aneuploidies and Microdeletions Using Cell-Free Fetal DNA
  • Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome
  • Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence
  • Percutaneous Tibial Nerve Stimulation
  • Pertuzumab (Perjeta)
  • Photodynamic Therapy for Choroidal Neovascularization
  • Preimplantation Genetic Testing
  • Radiation Therapy for Prostate Cancer
  • Radiation Treatment with Lutathera (Lutetium Lu 177 dotatate)
  • Radioactive Seed Localization of Nonpalpable Breast Lesions
  • Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors
  • Radiofrequency Ablation of the Renal Sympathetic Nerves as a Treatment for Resistant Hypertension
  • Sacral Nerve Neuromodulation or Stimulation
  • Sacroiliac Joint Arthrography
  • Sandostatin Sandostatin LAR depot (Octreotide) Somatuline Depo (lanreotide) Signifor LAR (pasireotide)
  • Septoplasty
  • Site of Service for Administration for Infusion and Injectable Prescription Medications
  • Sodium Hyaluronate Injections
  • Surgical Interruption of Pelvic Nerve Pathways for Primary and Secondary Dysmenorrhea
  • Testosterone [Implantable Testosterone Pellets (Testopel Pellets) Testosterone Undecanoate (Aveed)] Testosterone Cypionate (Depo-Testosterone) or Testosterone Enanthate (Delatestryl)]
  • Thermography
  • Threshold Electrical Stimulation as a Treatment of Motor Disorders
  • Total Artificial Hearts and Implantable Ventricular Assist Devices
  • Transesophageal Endoscopic Therapies for Gastroesophageal Reflux Disease
  • Ultrasound Accelerated Fracture Healing Device
  • Unna Boot
  • Ustekinumab (Stelara)
  • Vedolizumab (Entyvio)
  • Vitrectomy Chair or Vitrectomy Support System or Face-Down Positioning Device for Post-Vitrectomy Positioning
  • Whole Body Dual X-Ray Absorptiometry (DEXA) to Determine Body Composition

 

Click here to view the Blue Cross Blue Shield Horizon 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.

Back To Top