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  4. Medical Policies – New and Revised
  • August 14, 2020
  • Policy Benefits

Medical Policies – New and Revised

Medical policies are developed and revised in response to rapidly changing medical technology. Benefit determinations are made based on the medical policy in effect at the time of service.

The following medical policies were reviewed by the BCBSND Internal Medical Policy Committee on July 22, 2020.

NEW medical policies:

  • Percutaneous Left Atrial Appendage Closure Devices
  • Transcatheter Mitral Valve Repair Replacement
  • Radiofrequency Ablation of Peripheral Nerves to Treat Chronic Knee Pain
  • Bone Turnover Markers
  • Discectomy
  • Arthrex Bovine Collagen

REVISED medical policies

  • Feeding Disorder Program
  • Manipulations
  • Cardiac Application of Positron Emission Tomography Scanning
  • Experimental/Investigational Services
  • Cosmetic and Reconstruction Services

Medical policies with CODING CHANGES:

  • Durable Medical Equipment
  • Hematopoietic Cell Transplantation for Acute Lymphoblastic Leukemia
  • Removal of Benign and Premalignant Skin Lesions
  • Hematopoietic Cell Transplantation for Miscellaneous Solid Tumors in Adults
  • Bioengineered Skin Substitutes
  • Amniotic Membrane Amniotic Fluid
  • Ilizarov Bone Lengthening
  • Hematopoietic Cell Transplantation for CNS Embryonal Tumors and Ependymoma
  • Myoelectric Prosthetic Components for the Upper Limb
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