May 1, 2024

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:

  • Acute Inpatient Rehabilitation Level of Care
  • Ambulance Air and Water Transport
  • Auditory Brain Stem Implant
  • Benign Skin Lesion and Viral Infectious Lesion Removal
  • Bioimpedance Devices for Detection and Lymphedema
  • Chelation Therapy for Off-Label Uses
  • Chronic Intermittent Intravenous Insulin Therapy
  • Clinical Trials Medicare Advantage Plans
  • Constraint-Induced Movement Therapy
  • Cooling Devices used in the Home and Outpatient Setting
  • COVID-19 Diagnostic Testing, Vaccine and Antibody Treatment Administration Reimbursement  Policy ended 5/23/2023 at the end of PHE 
  • COVID-19 Monoclonal Antibody Treatment
  • Cranial Electrotherapy Stimulation and Auricular Electrostimulation
  • Dermatologic Applications of Photodynamic Therapy
  • Digestive Enzyme Cartridges 
  • Dry Hydrotherapy for Chronic Pain Conditions 
  • Durable Medical Equipment (DME)
  • Electrical and Electromagnetic Stimulation for the Treatment of Arthritis 
  • Emergency Room - Radiology Imaging
  • Hearing Aid Mandate
  • Human Leukocyte Antigen Testing Mandate 
  • Intraocular Radiotherapy for Age-Related Macular Degeneration 
  • Medical Records Standards
  • Medicare Advantage Plans Laboratory Network Hospital/Physician/Urgent Care Allowable Test Listing
  • Ophthalmology Examinations and Routine Eye Exams
  • Orthognathic Surgery
  • Prior Authorization of Drugs 
  • Provider Credentialing and Recredentialing
  • Reflectance Confocal Microscopy for Evaluating Skin Lesions for Suspected Malignancy
  • Self-Treatment or Treatment of Immediate Family Members
  • Steroid-Eluting Sinus Stents and Implants 
  • Surgery for Groin Pain in Athletes 
  • Surgical Ventricular Restoration 
  • Transurethral Water Jet Ablation (Aquablation) for Benign Prostatic Hypertrophy
  • Transvaginal and Transurethral Radiofrequency Tissue Remodeling for Urinary Stress Incontinence 
  • Vestibular Function 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 “Draft Medical Policies” drop-down.