Medical Policies Available Online

Blue Cross Blue Shield of North Dakota (BCBSND) regularly develops and revises medical policies in response to rapidly changing medical technology. Our commitment is to update the provider community as medical policies are adopted and/or revised. Benefit determinations are made based on the medical policy in effect at the time of service.

The following medical policies were reviewed by the Internal Medical Policy Committee on September 26, 2019. Please see policy for changes. Medical policies are available at www.bcbsnd.com/web/providers/policies.

The following policies are new or have been revised:

  • Leadless Pacemakers
  • Photodynamic Therapy (PDT) with Porfimer Sodium
  • Chelation Therapy for Off-Label Uses
  • H-wave Electrical Stimulation
  • Electronystagmography (ENG) and Videonystagmography (VNG) Services
  • Excision Repair Cross-Complementing Factor 1 (ERCC1) Analysis for Non-Small Cell Lung Cancer
  • Ambulatory and Outpatient Cardiac Hemodynamic Monitoring of Heart Failure
  • Responsive Neurostimulation for the Treatment of Refractory Partial Epilepsy
  • Home Dialysis Equipment and Supplies
  • Impedance Cardiography in Hypertension
  • Small Bowel, Small Bowel/Liver and Multivisceral Transplantation
  • Transcatheter Closure Devices for Septal Defects
  • Experimental/Investigational Services
  • Amniotic Membrane and Amniotic Fluid
  • Bioengineered Skin and Soft Tissue Substitutes (aka Bioengineered Skin)
  • Oxygen
  • WATS3D Biopsy (EndoCDx)
  • Prophylactic Mastectomy
  • Intravitreal Implants
  • Lower Limb Prosthesis
  • Desensitization Treatment for Heart and Renal Transplant
  • Diagnosis and Treatment of Male Sexual Dysfunction
  • Wearable Cardioverter-Defibrillator
  • Treatment of Hyperhidrosis
  • Balloon Ostial Dilation of the Sinus and Implantable Sinus Stents
  • Laboratory Studies for Diagnosing and Managing Inflammatory Bowel Disease
  • Ambulatory Blood Pressure Monitoring (ABPM)
  • Treatment of the Prostate
  • Obesity
  • Solitary Pancreas Transplantation
  • Biofeedback
  • Allergy Testing
  • Cosmetic and Reconstructive Surgery
  • Drug Testing in Pain Management and Substance Abuse Treatment
  • Kyphoplasty
  • Vertebroplasty
  • Lung and Lobar Lung Transplantation
  • Allogeneic Hematopoietic Cell Transplantation for Genetic Diseases and Acquired Anemia
  • Intraocular Lens
  • Intraoperative Monitoring
  • Pap Smear
  • Foot care
  • Foot Orthotics
  • Cardiac Ablation Procedures
  • Cardiac Monitors
  • Diagnosis and Treatment of Obstructive Sleep Apnea for Adults
  • Physical Medicine
  • Biomarkers in Risk Assessment and Management of Cardiovascular Disease