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

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
DMP0617-10 Avelumab 06/26/17 07/26/17
DMP0617-11 Osteochondral Allografting 06/28/17 07/28/17
DMP0617-12 Eribulin Mesylate 06/29/17 07/29/17`
DMP0617-13 Osteochond Autograft 06/29/17 07/29/17
DMP0717-01 Magnetic Resonance Imaging (MRI) of the Breast 07/06/17 08/06/17


07/06/17 08/06/17

Ablation Procedures for Peripheral Neuromas

07/06/17 08/06/17

Whole Exome and Genome Sequencing

07/06/17 08/06/17

Implantable Hypoglossal Nerve Stimulation

07/11/17 08/11/17

Home Hyperalimentation (Total Parenteral / Enteral Nutrition)

07/12/17 08/12/17
DMP0717-07 Noninvasive Techniques for Evaluation and Monitoring of Chronic Liver Diseases 07/19/17 08/19/17

Orthognathic Surgery

07/19/17 08/19/17

Cardioverter Defibrillators

07/20/17 08/20/17


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