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BCBS Horizon Medical Policy Updates – October 2018
Click here to view the Blue Cross Blue Shield Horizon Medical Policy Updates »
October 2018 Medical Policy Updates:
- Agalsidase Beta (Fabrazyme)
- Allogeneic Pancreas Transplant
- Assisted Reproductive Technologies
- Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions
- Belimumab (Benlysta)
- Biofeedback
- Botulinum Toxin
- Chiropractic Review Policy
- Composite Tissue Allotransplantation of the Hand and Face
- Computed Tomography (CT) Perfusion Imaging of the Brain
- Discography
- Drug Therapy for Hereditary Angioedema [Cinryze Berinert Haegarda (Human C1 Inhibitor) Kalbitor (Ecallantide) Firazyr (Icatibant) Ruconest (C1 Esterase Inhibitor [Recombinant])]
- Eculizumab (Soliris)
- Epidural Steroid Injections
- Epidurography Radiological Supervision and Interpretation
- Facet Joint Injections or Medial Branch Blocks
- First Trimester Screening for Chromosomal Abnormalities using Fetal Ultrasound Assessment of Nuchal Translucency Combined with Maternal Serum Assessment
- Foot Care Services
- Gait Trainers and Standing Frames
- Gaucher Disease Therapy
- Genetic Testing for Lynch Syndrome and Other Inherited Colon Cancer Syndromes
- Gonadotropin-Releasing Hormone Analogs
- Heart or Lung Transplant
- Heart Transplant
- Immune Globulin Subcutaneous (Vivaglobin Hizentra Gammagard Liquid Gamunex-C or Gammaked HyQvia and Cuvitru for Subcutaneous Administration)
- Implantable Intrathecal Drug Delivery Systems
- Injectable Bulking Agents for the Treatment of Urinary Incontinence
- Intravenous Immunoglobulin (IVIG) Therapy
- Invasive Prenatal (Fetal) Diagnostic Testing
- Islet Transplantation
- Isolated Small Bowel Transplant
- Kidney Transplant
- Laparoscopic and Percutaneous Techniques for the Myolysis of Uterine Fibroids
- Laronidase (Aldurazyme) Galsulfase (Naglazyme) and Idursulfase (Elaprase) elosulfase alfa (Vimizim) and vestronidase alfa (Mepsevii)
- Liver Transplant and Combined Liver-Kidney Transplant
- Lung and Lobar Lung Transplant
- Meniscal Allografts and Other Meniscal Implants
- Multigene Expression Assay for Predicting Recurrence in Colon Cancer
- Nivolumab (Opdivo)
- Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome
- Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence
- Pemetrexed Disodium (Alimta)
- Percutaneous Neurolysis for Trigeminal Neuralgia
- Percutaneous Tibial Nerve Stimulation
- Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux (VUR)
- Pompe Disease Treatment with Myozyme (Alglucosidase alfa) and Lumizyme (Alglucosidase alfa)
- Preimplantation Genetic Testing
- Radiofrequency Joint Ablation or Denervation
- Regional Sympathetic Blocks
- Rhinomanometry and Acoustic or Optical Rhinometry
- Sacroiliac Joint Injections
- Scintimammography and Gamma Imaging of the Breast and Axilla
- Serum Biomarker Tests for Multiple Sclerosis
- Site of Service for Administration for Infusion and Injectable Prescription Medications
- Small Bowel or Liver and Multivisceral Transplant
- Spinal Cord and Implantable Peripheral Nerve Stimulators
- Standards for Diagnostic Radiology or Imaging Facilities or Freestanding-Office including Surgi-Centers and Diagnostic Dental – Radiographic Imaging
- Thermography
- Total Artificial Hearts and Implantable Ventricular Assist Devices
- Trastuzumab (Herceptin) Trastuzumab-dkst (Ogivri) and Ado-trastuzumab emtansine (Kadcyla)
- Trigger Point Injections
- Unna Boot
- Ustekinumab (Stelara)
- 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
- Work Hardening or Conditioning Programs
- Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions
- Bioengineered Skin and Soft Tissue Substitutes
- Bone Mineral Density Studies and Vertebral Fracture Assessment With Densitometry
- Dermatologic Applications of Photodynamic Therapy
- Erwinaze (Asparaginase Erwinia Chrysanthemi) and Oncaspar (pegaspargase)
- Genetic and Protein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer
- Hip Resurfacing
- Non Oral Drug Therapy for Pulmonary Hypertension
- Noninvasive Prenatal Screening for Fetal Aneuploidies and Microdeletions Using Cell-Free Fetal DNA
- Obstetrical Ultrasound Policy
- Photodynamic Therapy for Choroidal Neovascularization
- Total Ankle Replacement (Arthroplasty)
- Transplant Donor and Recipient Policy
Click here to view the Blue Cross Blue Shield Horizon Medical Policy Updates »
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