Blue Cross Blue Shield North Carolina October 2017 Medical Policy Updates

Blue Cross Blue Shield North Carolina Medical Policy Updates
Blue Cross Blue Shield North Carolina 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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