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1 Mar, 2020

Policies recently reviewed for annual update

The following policies were recently reviewed for annual update. The full texts of these policies are available in the Provider section of bcbsri.com.

  • Anesthesia Services
  • Asthma Management Services
  • Breast Ductal Lavage for Detection of Breast Cancer
  • Chiropractic Services
  • Chromoendoscopy as an Adjunct to Colonoscopy
  • Coordination of Benefits
  • Digital Breast Tomosynthesis
  • Discarded Drugs and Biologicals
  • Endometrial Ablation
  • Genetic Testing Services
  • Health and Behavior Assessment
  • Hospital Readmission
  • Hospital Utilization Review
  • Immune Cell Function Assay
  • Inpatient Admissions
  • Islet Cell Transplant
  • Knee Walker
  • Mastectomy Treatment, Breast Reconstruction and Hospital Stays Mandate
  • Measurement of Exhaled Nitric Oxide and Exhaled Breath Condensate in the Diagnosis and Management of Respiratory Disease
  • Measurement of Serum Antibodies to Selected Biologic Agents (formerly titled: Measurement of Serum Antibodies to Infliximab and Adalimumab)
  • Measurement of Small Low-Density Lipoprotein (LD) Particles
  • Non-Reimbursable Health Service Codes
  • Prior Authorization of Drugs
  • Prior Authorization via Web Based Tool for Durable Medical Equipment (DME)
  • Prior Authorization via Web Based Tool for Procedures
  • Pulsed Radiofrequency for the Treatment of Chronic Pain
  • Serum Biomarker Human Epididymis Protein 4
  • Spravato (esketamine)
  • Unlisted Procedures
  • Urinary Biomarkers for Cancer Screening, Diagnosis and Surveillance
  • Visual Screening for Children Ages 0-5 years
  • Vitamin-D Testing

We also post monthly drafts of medical policies being created or reassessed for your review. As a reminder, you can provide comments on draft policies for up to 30 days. Draft policies are located on the Provider homepage, under the Medical Policies section, under the drop-down “Draft Medical Policies."