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.


Policy Posted
Policy Removed
DMP1219-10 Ravulizumab-cwvz 12/31/19 01/31/20
DMP1219-11 Serum Antibodies for the Diagnosis and Management of Inflammatory Bowel Disease 12/31/19 01/31/20
DMP0120-01 Romiplostim 01/03/20 02/03/20
DMP0120-02 Panitumumab 01/03/20 02/03/20
DMP0120-03 Carfilzomib 01/03/20 02/03/20
DMP0120-04 Bortezomib (Velcade) 01/03/20 02/03/20
DMP0120-05 Cemiplimab-rwlc 01/07/20 02/07/20
DMP0120-06 Durvalumab 01/08/20 02/08/20
DMP0120-07 Givosiran 01/08/20 02/08/20
DMP0120-08 Brentuximab Vedotin 01/08/20 02/08/20
DMP0120-09 Crizanlizumab-tmca 01/08/20 02/08/20
DMP0120-10 Ipilimumab 01/10/20 02/10/20
DMP0120-11 Trastuzumab and Hyaluronidase-oysk 01/10/20 02/10/20
DMP0120-12 Rituximab and Hyaluronidase Human Injection 01/10/20 02/10/20
DMP0120-13 Omacetaxine Mepesuccinate 01/14/20 02/14/20
DMP0120-14 Enfortumab Vedotin-ejfv 01/15/20 02/15/20
DMP0120-15 Nelarabine 01/15/20 02/15/20
DMP0120-16 Eribulin Mesylate 01/17/20 02/17/20
DMP0120-17 Voretigene Neparvovec-rzyl 01/17/20 02/17/20


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