Draft Medical Policies
BlueCross BlueShield of Tennessee

BlueCross BlueShield of Tennessee works to ensure that Medical Policies are developed in an open, collaborative manner with our providers. We invite you to submit comments during the development phase of our Medical Policies.

Medical policies are developed using an evidence-based evaluation process. The medical evidence used in this process comes from several sources, including independent medical technology review organizations, the peer reviewed medical literature, and expert opinions from BCBST network specialists. We especially welcome comments that include this type of information. All Medical Policies are reviewed and approved by a panel of BCBST Medical Directors as well as board certified network physicians before final adoption by the company.

Tracking Number

Medical Policy Name

Beginning of Comment Period

End of Comment Period

DMP0517-06 Ramucirumab 05/31/17 06/30/17
DMP0517-07 Trabectedin 05/31/17 06/30/17

Bio-Engineered Skin and Soft Tissue Substitutes

06/01/17 07/01/17

Human Amniotic Membrane Grafts and Amniotic Fluid Injections

06/01/17 07/01/17


06/05/17 07/05/17


06/14/17 07/14/17
DMP0617-05 Ofatumumab 06/15/17 07/15/17
DMP0617-06 Detection and Quantification of Circulating Tumor DNA (Liquid Biopsy) and Circulating Tumor Cells in the Management of Individuals with Cancer 06/21/17 07/21/17
DMP0617-07 Palonosetron 06/22/17 07/22/17

Genetic Testing for Mitochondrial Disorders

06/22/17 07/22/17

Molecular Markers in Fine Needle Aspirates of the Thyroid

06/22/17 07/22/17


Medical Policy Comments:

Please reference the policy name or tracking number in your comments.
To submit comments about the draft Medical Policies:
Click the “Medical Policy Comments” above or click here: Comments or Feedback.

Comments can also be mailed to:

BlueCross BlueShield of Tennessee
Medical Policy
1 Cameron Hill Circle
Chattanooga, TN 37402