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

    DMP1218-16 Aqueous Shunts and Stents for Glaucoma 12/21/18 01/21/19
    DMP0119-01 Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders 01/02/19 02/02/19
    DMP0119-02 Trastuzumab 01/02/19 02/02/19
    DMP0119-03 Trastuzumab-pkrb 01/02/19 02/02/19
    DMP0119-04 Azacitidine 01/04/19 02/04/19
    DMP0119-05 Rituximab-abbs 01/04/19 02/04/19
    DMP0119-06 Emapalumab-lzsg 01/10/19 02/10/19
    DMP0119-07 Pneumatic Compression Pumps 01/14/19 02/14/19
    DMP0119-08 Asparaginase Erwinia chrysanthemi 01/15/19 02/15/19
    DMP0119-09 Pegaspargase 01/15/19 02/15/19
    DMP0119-10 Belinostat 01/17/19 02/17/19


    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