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Blue Cross Blue Shield North Carolina October 2017 Medical Policy Updates
Click here to view the Blue Cross Blue Shield North Carolina October 2017 Medical Policy Updates »
Notification of Policy Revisions Effective October 13, 2017:
Medical Policy |
Revision |
|---|---|
| Acute and Maintenance Tocolysis | Policy Guidelines and references updated. Specialty Matched Consultant Advisory Panel review 9/27/2017. No change to policy statement. |
| Assays of Genetic Expression to Determine Prognosis of Breast Cancer | Extensive updates to Description and Policy Guidelines sections. Under “When Not Covered” section: removed Prosigna from statement #3 for clarity. No change to policy statement. Reference added. |
| Bone Mineral Density Studies | Specialty Matched Consultant Advisory Panel review 9/27/2017. No change to policy statement. |
| Cardiac (Heart) Transplantation | Description section updated. Policy Guidelines extensively updated; no change to policy intent. Reference updated. Medical Director review. |
| Children’s Mobility and Positioning Equipment | Specialty Matched Consultant Advisory Panel review 9/2017. Medical Director review 9/2017. |
| Chiropractic Services | Specialty Matched Consultant Advisory Panel 9/2017. Medical Director review 9/2017. |
| Denosumab (ProliaTM, XGEVATM) | Specialty Matched Consultant Advisory Panel review 9/27/2017. No change to policy statement. |
| Dry Needling of Myofascial Trigger Points | Specialty Matched Consultant Advisory Panel review 09/2017. Medical Director review 09/2017. |
| Durable Medical Equipment (DME) | Specialty Matched Consultant Advisory Panel review 9/30/2017. Medical Director review 9/2017. |
| Electronic Brachytherapy for Nonmelanoma Skin Cancer | Corrected date for above note 8/25/16 should read 8/25/17. |
| Endothelial Keratoplasty | Reference added. |
| Exhaled Nitric Oxide Measurement | Added CPT 94799 to Billing/Coding section. Updated Description and Policy Guidelines sections. No change to policy statement. Reference added. |
| Functional Capacity Assessment and Work Hardening | Specialty Matched Consultant Advisory Panel 9/2017. Medical Director review 9/2017. |
| Genetic and Protein Biomarkers for Diagnosis and Risk Assessment of Prostate Cancer | Deleted CPT 0010M from the Billing/Coding section. |
| Genetic Testing for Lactase Insufficiency | Minor revision to Description section and extensive update to Policy Guidelines. Genetic nomenclature updated throughout policy; no change to policy intent. References updated. Medical Director review. |
| Heart-Lung Transplantation | Minor update to Description section. Extensive revision to Policy Guidelines; no change to policy intent. References update. Medical Director review 9/2017. |
| Hyperthermia Therapy | Specialty Matched Consultant Advisory Panel review 8/30/2017. No change to policy statement. |
| In Vitro Chemoresistance and Chemosensitivity Assays | Updated Policy Guidelines section. Reference added. No change to policy statement. |
| Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers) | Code C1821 added to Billing/Coding section. Notification given 8/11/2017 for effective date 10/13/2017. |
| Laparoscopic and Percutaneous Techniques for the Myolysis of Uterine Fibroids | Reference added. Specialty Matched Consultant Advisory Panel review 9/27/2017. No change to policy statement. |
| Microwave Tumor Ablation | Reference added. |
| Molecular Analysis for Targeted Therapy for Non-Small Cell Lung Cancer (NSCLC) | Specialty Matched Consultant Advisory Panel review 8/30/2017. CPT 0022U added to Billing/Coding section. No change to policy statement. |
| Multitarget Polymerase Chain Reaction Testing for Diagnosis of Bacterial Vaginosis | Description section updated. Policy Guidelines section updated. References added. Specialty Matched Consultant Advisory Panel review 9/27/2017. No change to policy statement. |
| Orthopedic Applications of Stem Cell Therapy | Reference added. Codes C9359 and C9362 added to Billing/Coding section. Notification given 8/11/2017 for effective date 10/13/2017. |
| Patient Lifts | References updated. Specialty Matched Consultant Advisory Panel review 9/2017. Medical Director review 9/2017. |
| Polysomnography for Non-Respiratory Sleep Disorders | Reference added. |
| Pressure Reducing Support Surfaces | References updated. Specialty Matched Consultant Advisory Panel 9/2017. Medical Director review 9/2017. |
| Rehabilitative Therapies | References updated. Specialty Matched Consultant Advisory Panel review 9/2017. Medical Director review 9/2017. |
| Respiratory Syncytial Virus Prophylaxis | Reference added. |
| Speech Generating Devices | References updated. Specialty Matched Consultant Advisory Panel review 9/2017. Medical Director review 9/2017. |
| Wheelchairs (Manual and Power Operated) | Specialty Matched Consultant Advisory Panel review 9/2017. Medical Director review 9/2017. |
| White Blood Cell Growth Factors | Added HCPCS Q5101 to the Billing/Coding section. |
Click here to view the Blue Cross Blue Shield North Carolina October 2017 Medical Policy Updates »
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