1 Jul, 2022

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:

  • Adult Intensive Services (AIS) and Child and Family Intensive Services (CFIT)
  • Axial Lumbosacral Interbody Fusion
  • Behavioral Health Supervisory Protocol for Licensed Clinical Social Workers and Post Doctorate Clinicians
  • Corneal Topography, Computer Assisted Corneal Topography, Photokeratoscopy
  • Cranial Orthoses (Adjustable) for Positional Plagiocephaly and Craniosynostoses         
  • Dry Needling of Trigger Point for Myofascial Pain
  • Epidural Injections for Pain Management
  • Functional Neuromuscular Electrical Stimulation
  • Intravitreal and Punctum Corticosteroid Implants
  • Nerve Graft with Radical Prostatectomy
  • Ocriplasmin for Symptomatic Vitreomacular Adhesions
  • Orthognathic Surgery
  • Out-of-Network Services Requests
  • Outpatient Pulmonary Rehabilitation
  • Patient-Controlled End of Range Motion Stretching Devices
  • Phototherapy in the Home for the Treatment of Dermatological Conditions
  • Powered Exoskeleton for Ambulation in Patients with Lower-Limb Disabilities
  • Psychological and Neuropsychological Testing
  • Prostatic Stent – Temporary
  • Reflectance Confocal Microscopy for Evaluating Skin Lesions for Suspected Malignancy.
  • Rhinomanometry and Acoustic Optical Rhinomanometry
  • Risk Reducing Mastectomy
  • Signal-Averaged Electrocardiography (SAECG)
  • Skin Contact Monochromatic Infrared Energy (MIRE)
  • Sympathetic Therapy for Pain Treatment
  • Thermal Capsulorrhaphy as a Treatment of Joint Instability
  • Thoracic Lumbosacral Orthosis with Pneumatics
  • Topographic Brain Mapping
  • Transanal Radiofrequency Treatment of Fecal Incontinence
  • Transpupillary Thermotherapy for Treatment of Choroidal Neovascularization
  • Transvaginal and Transurethral Radiofrequency Tissue Remodeling for Urinary Stress Incontinence
  • Viscocanalostomy and Canaloplasty

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."

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