Upcoming Medical Policies
BlueCross BlueShield of Tennessee

Each medical policy listed below will become effective on the date indicated, and will be included in the Medical Policy Manual for BlueCross BlueShield of Tennessee on that effective date.

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 opinions from appropriate network specialists. All Medical Policies are reviewed by a panel of internal and external physicians before being adopted by the company.

Topics due to be included in the Medical Policy Manual on 12/10/16

Topics due to be included in the Medical Policy Manual on 12/21/16

Topics due to be included in the Medical Policy Manual on 1/14/2017

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Topics due to be included in the Medical Policy Manual on 12/10/2016:

Bio-Engineered Skin and Soft Tissue Substitutes

Intravenous Immune Globulin (IVIG) Therapy

Nerve Graft Prostatectomy

Subcutaneous Immune Globulins

Topics due to be included in the Medical Policy Manual on 12/21/2016:

Nivolumab

Transcranial Magnetic Stimulation (TMS)

Topics due to be included in the Medical Policy Manual on 1/14/2017:

Digital Breast Tomosynthesis (3D Mammogram)

Fractional Laser Treatment of Vulvovaginal Atrophy

Magnetic Resonance Imaging (MRI) of the Breast

Proteogenomic Testing for Individuals with Cancer

Tumor-Treatment Fields Therapy for Glioblastoma


Last Review Date 12/1/2016

Medical Policy Comments:

Please reference the policy name in your comments.
To submit comments about the upcoming 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