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.”